2.2 Assess existing resources and capacity
The rapid assessment will provide a general indication of the needs and capacity to respond. The health cluster, and RMNCAH/CAH working group, should expand on this with a more thorough assessment of health service resources and capacity.
Key actions – health service assessment
Adapted from the Sphere Health Standards (1)
- The RMNCAH/CAH working group coordinates additional assessment of CAH needs and response capacity in collaboration with the health cluster lead, and the health cluster information management working group.
- Review existing policies and protocols related to CAH care.
- Avoid reinventing programmes and protocols that already exist, or developing new recommendations that may conflict with current standards. If existing policies are lacking, involve the government in creating new policies.
- If communication between government and international or local nongovernmental organizations is challenging, invite UN organizations (e.g. WHO) to facilitate dialogue and ensure that national policies align with international standards.
- Review existing CAH clinical guidelines to ensure that they are up to date and appropriate. Review health promotion and communication tools and health care worker training materials. If new guidelines or tools need to be created, work collaboratively with government, UN agencies, and international and local nongovernmental organizations.
- Map existing health facilities, assess their current status, including functional capacity, CAH service availability and damage – use the Health Resources Availability Monitoring System (HeRAMS) (27), Service Availability and Readiness Assessment (SARA) (28), 3W/4W (31) or tools for use in the field (4). Include private and “traditional” care providers. Where possible, assess access to and use of health services and identify possible threats (e.g. security and transport). Where available, use pre-existing service coverage data (e.g. measles immunization and antenatal care coverage).
- Review existing staffing levels using national standards and classifications of job functions, if available, adapting to the emergency setting. Document the number and type of skilled health care providers at health facilities and where they work (e.g. within the facility, outreach and mobile clinic). Use simple questionnaires to assess health care provider competency in essential CAH health services, and identify training needs and opportunities.
- Review the existing national essential medicines and medical device list early in the response. Clarify procurement and distribution procedures and possible challenges. Help staff address urgent issues with supplies (See section 3.4).
- The RMNCAH/CAH working group should assist the health cluster lead to collate the information on health facilities and create a service map showing existing service availability, strengths and weaknesses (Box 9). Use the service map to coordinate service planning and priority-setting with partner organizations, and ensure it is regularly revised. Share the service map with decision-makers, partners and the community.
Key indicators – health service assessment
- The RMNCAH/CAH working group has prepared a plan (with the health cluster lead) to conduct additional assessments of CAH needs and response capacity. The plan includes a timeline of activities and designates responsibility.
- The RMNCAH/CAH working group has helped the health cluster lead to create and disseminate a service map.
Box 9 Service map of existing service availability
Important elements to include in a service map
- Geographical locations. Existing health care networks.
- Distances from affected communities (including mobile and outreach services). Distances between peripheral health facilities and larger hospitals.
- Transport options between locations, and potential access issues (e.g. security risks, safety issues and cultural factors).
- Communications systems (e.g. telephone and Internet).
- Health services provided (preventive and curative). Medicines and medical supplies. Costs.
- Staff-to-patient ratios (e.g. doctors and nurses per 10 000 population).
4 These interventions may include preventative and curative health interventions, as well as a range of broader public health and social activities (e.g. water and sanitation and food security).
5 Child populations at high risk are outlined Box 8, Section 2.1.
6 See Annex 4 for a list of essential health interventions to consider.
7 See Box 8 Section 2.1 for groups at very high risk.