capacity building for health workforce first national course on public health emergency management...

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


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


Defining Capacity

Sum of:

capabilityresources

relationships

Within

communityorganization

countryregionworld

Aims

– Reducing illness, disability and death from risks

– Promoting health, safety and security


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


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


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


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


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


ElementsOf capacity toPerformFunctions

OrganizationsSystemsPeople


Organizations

In the context of health emergency:

• Designated/organized body • Defined organizational structure• Clear roles and directions• United action or functions• Legal framework


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)


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


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


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


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


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


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


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


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


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


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


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


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


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


• Legal framework• Policies• Guidelines• Procedures• Resources• Plans• Knowledge• Attitude• Skills

Organizations

Systems

People

Elements Of capacity To manage Health risks of emergencies


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


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


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


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


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)


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

capacity building for health workforce first national course on public health emergency management...

Documents

health emergency manager

oman health workforce

better capacity

capacity sum

traditional health workers

health risks of emergencies

reduceprevent hazard

health physician nursing