capacity building for health workforce first national course on public health emergency management...
TRANSCRIPT
Capacity Building for Health Workforce
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
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
Health Workforce
all persons currently participating in the health labor market
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
Defining Capacity
Sum of:
capabilityresources
relationships
Within
communityorganization
countryregionworld
Aims
– 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
Risk = Hazard x Vulnerability Capacity
In managing Risk: Capacity is needed to:
• Reduce Hazard• Reduce vulnerability• Increase Capacity
Relevance of Risk Management to HEM Capacity Development
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
Reduce vulnerability
Respond to reduce and manage Response consequences
Recover and reconstruct for better Recovery
Preparedness
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Disaster Risk Management Framework
(Capacity utilization)
(Capacity building)
(Capacity rebuilding for better)
(Capacity to Reduce/preventHazard)
(Capacity to Lessen Impact of hazard)
Response
RecoveryPreparedness
MitigationPrevention
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
ANATOMY OF COMMUNITY RISK MANAGEMENT
hazard
communityvulnerability
readiness
multisectoral, all hazards
Community risk
indicators: indicators:indicators:indicators:probabilityscale/magnitude/ strength/intensityspreadduration
biological hazards: season, infectivity, latency, transmission resistance, etc.natural phenomenafaminediseases of epidemic potentialevents/crowdsintoxificationinfestationstransport accidentsstructural failuresindustrial accidentschemical accidentspollutionrefugeeswarterrorism
Prevention & MitigationProgramme
=
=
People:access to health
caremeasles
vaccinationunder 5 nutritionunder 5 mortality
access to clean water
access to sanitation
adequate housingemployment/
incomefemale literacy
Property:health
infrastructurevehicles
medical supplies
Services:curative care
servicesambulance
servicespublic health
serviceshealth info system
Environment:water/soil/air
quality
Vulnerability Reduction Programme
policy, plans, proceduresknowledge, skills, attitudesresources
legislationnational & sectoral policyadministrative proceduresresponse & recovery planspreparedness planstechnical guidelinesmanagement structureinstitutional managementsinformation systemswarning systemshuman resourcesmaterial resourcesfinancial resourcessimulations & trainingeducationpublic informationcommunity participationresearchpublications
Emergency PreparednessProgramme
risk of:death
injury (mental/ physical)
disease (mental/physical)
loss of lifedisplacement
loss of propertyloss of income
secondary hazardsbreakdown in
securitydamage to
infrastructurebreakdown in
servicesContamination
Community Risk Management
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
ElementsOf capacity toPerformFunctions
OrganizationsSystemsPeople
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Organizations
In the context of health emergency:
• Designated/organized body • Defined organizational structure• Clear roles and directions• United action or functions• Legal framework
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Systems
Definition:
a “regularly interacting or interdependent group of items forming a unified whole” (Merriam Webster Dictionary)
an orderly grouping of facts, principles, or methods in a certain field; any formulated method or plan; a manner of arrangement or procedure
(The Random House Dictionary)
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Systems to Manage Health Risks of Emergencies
Systems
• systems operating at each administrative level
• systems in specific sectors
• systems to manage specific types of risks (hazards and vulnerabilities)
• systems for specific functions or services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
People
People contribute to organizations and systems by providing:• skills, knowledge and attitudes • Competency
People may be: • Career (or paid), volunteer and community• Managers, coordinators, operators or responders
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Evacuation Site Scenario
• Damaged lifelines• Overcrowding• Poor environmental sanitation• No access to safe water• Inadequate sanitary toilets• Health workers are direct victims• Disrupted basic health services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Evacuation Site Scenario: Typhoon
•Poor environmental sanitation• No access to safe water• Inadequate sanitary toilets• No community surveillance system• Disrupted basic health services• Foul smell of decomposing bodies• Severe depression of the bereaved and other health workers
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Group Activity 1
In your group, address one of the following:
1. Poor environmental health condition 2. Disrupted communicable disease services3. Poor management of the dead and the
missing4. Lack of mental health and psychosocial
support
Assess the risk and identify capacity needed in terms of organization, systems and people. Write your answers on a flip chart for presentation.Risks Services/
FunctionsCapacities needed
Organization System People
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Environmental Health in Evacuation Center
Environmental health risks are assessed, including:• Water supply services• Waste handling and disposal• Food safety• Garbage disposalLocal Capacity ( laboratory services, sampling, diagnosis
and analysis; equipment etc.)Inventory of organizations with environmental health
roles and responsibilities (laboratories, surveillance, chemical industries, water supply services, waste disposal services, fire service, etc.)
Availability of supplies, reagents, medicines
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Environmental Health in Evacuation Center
Environmental health risks:• Food and water borne diseases
Environmental Capacity• Environmental assessment, surveillance• Environmental teams• Environmental logistics including systems of
distribution• Laboratories and other confirmation devices• Reporting, monitoring, evaluation
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Communicable Disease
Communicable health risks are assessed including:• Diseases of Epidemic Potential• Vaccine Preventable Diseases• Vector Born Diseases• Diseases of Public Health Significance
Considerations:• Health status• Local capacity, program implementation• Inventory of Organizations• Availability of health services, facilities• Availability of drugs, medicines, supplies, vaccines
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Communicable Disease Communicable health risks:• Epidemic and Outbreak
Communicable Disease Capacity• Surveillance System in place in evacuation
centers• Surveillance teams available • Case definition etc..• Epidemiological investigation• logistics including systems of distribution• Laboratories and other confirmation devices• Reporting, monitoring, evaluation• Networking and referral system
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Management of the Dead and Missing
MDM Issues:• Identification of the Dead• Cultural Considerations• Final Disposal of the Dead• Management of the RelativesConsiderations:Legal framework, functioning coordination mechanisms and
organizational structure in place for health emergency preparedness and response
Local capacityInventory of OrganizationsMortuary System
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Management of the Dead and Missing
MDM health risks?• Myths and realities about dead bodies• Mass burialMDM Capacity• Organizational/Institutional Arrangements; roles and
responsibilities; management structures• Procedures (identification, keeping of records,
fingerprinting, dental records, DNA and photographing)• Provisions for notification of relatives (next of kin)• Logistics• Reporting, monitoring, evaluation• Networking and referral system
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Mental Health and Psychosocial Support
Psychosocial health risk assessment:• Coverage• Silent victims, Family displacement• Medical Responders/Leaders• Early identification and referral
Considerations:• Local capacity for emergency provision of
essential services and supplies• Inventory of organizations, health facilities,Availability of drugs, medicines, supplies, Availability of training modules and trainers
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Mental Health and Psychosocial Support Psychosocial health risks:• Long lasting; affects rehabilitation and recovery
(children, responders, etc.)Psychosocial Capacity• Policies and Plan• Training modules, pool of trainers ; range of
services• Advocacy and awareness through education,
information management and communication • Health facilities, drugs and medicines• Reporting, monitoring, evaluation• Networking and referral system; Inter and Intra
sectoral coordination • Local capacity for emergency provision of
essential services and supplies
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
• Legal framework• Policies• Guidelines• Procedures• Resources• Plans• Knowledge• Attitude• Skills
Organizations
Systems
People
Elements Of capacity To manage Health risks of emergencies
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
EMERGENCY AND HEALTH
EMERGENCY
COMMUNITY
VULNERABILITIES CAPACITIES
DIRECT IMPACT
INDIRECT IMPACT
ASSOCIATED FACTORS
Climate/ weather/ time of the day
Location
Security situation
Political environment
Economic environment
Socio-cultural environment
Morality, solidarity, spirit
Competence, corruption
DAMAGE AND NEEDS
RESPONSE CAPACITIES
Search and rescue
First Aid
Triage
Medical evacuation
Primary care
Disease surveillance and control
Curative care
Blood banks
Laboratories
Referral system
Special units (burn, spinal)
Evacuation centers
Shelter and Water
Food and nutrition
Energy and Security
Environmental health
Primary Health Care
Care of the dead
Psychosocial care
Disability care
Recovery and Reconstruction
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
EPIDEMIC EMERGENCIES
OUTBREAK
Specific morbidity and mortality
- in the community
- in health facilities
- in health facilities
Risk for health and lab workers
Difficult access
Agent unknown
RESPONSE CAPACITIES
Case definition
Admission criteria
Case confirmation
Case management
Discharge criteria
Contact tracing
Vector control
Environmental controls
Surveillance system
Referral system
Professional education
Public Information and awareness
Laboratory plans
Hospital plans
Supplies and equipment
Borders control
Quarantine
Animal culling
Commerce/ trade
NEEDS
First National Course on Public Health Emergency Management 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