Emergencies

Health in Humanitarian Action

CCC Commitments and Benchmarks

Commitments Benchmarks
Commitment 1

Inter-agency coordination mechanisms in the health sector (e.g., cluster coordination) are supported and enhanced with links to other cluster/sector coordination mechanisms on critical intersectoral issues.

Policy  |  Tools
 
Benchmark 1

Health programme initiated by UNICEF and its partners contributes to the development of inter-agency strategy and implementation plans and ensures that activities are in line with it.

Commitment 2

Children and women access life-saving interventions through population- and community-based activities (e.g., campaigns and child health days).

Policy  |  Tools
 
Benchmark 2

95% coverage with measles vaccine, vitamin A and deworming medication in the relevant age group of the affected population. All families in the affected area receive two insecticidetreated bed nets in malaria-endemic areas.

Commitment 3

Children, adolescents and women equitably access essential health services with sustained coverage of high-impact preventive and curative interventions.

Policy  |  Tools
 
Benchmark 3

90% of children aged 12-23 months fully covered with routine EPI vaccine doses; no stock-outs of antibiotics (tracer for health), oxytocin (tracer for basic emergency obstetric and newborn care services), iron/folic acid (tracer for antenatal care) and antiretrovirals (tracer for prevention of mother-to-child transmission) in health centres in affected areas; at least one basic emergency obstetric care facility per 100,000 people.

Commitment 4

Women and children access behaviour-change communication interventions to improve health-care and feeding practices.

Policy  |  Tools
 
Benchmark 4

All affected populations are exposed to key health education/promotion messages through multiple channels.

Commitment 5

Women and children have access to essential household items.

Policy  |  Tools
 
Benchmark 5

90% of affected population has access to essential household items.

Technical Justification

The CCCs for health are based on addressing the major causes of maternal, neonatal and child mortality through evidenced-based interventions, inter-agency agreements and existing inter-agency standards (e.g., Sphere Standards). In the immediate post-emergency phase, direct causes, such as injuries or violence, may account for a substantial number of deaths. In protracted humanitarian situations, most deaths are attributable to common health conditions prevalent in the community, such as malnutrition, pneumonia, diarrhoea, measles, malaria (in malaria-endemic areas) and neonatal causes. The actual package of interventions will therefore vary depending on the context. UNICEF is committed to supporting the continuum of care across the maternal, newborn and early childhood period, acknowledging that maternal health is critical in ensuring healthy babies and children. UNICEF also supports the continuum of care from the household, community and health facility, with an increasing emphasis on community health approaches.

Programme Action

  • Preparedness
  • Response
  • Early Recovery

Preparedness

  • Clarify the responsibilities of UNICEF and its partners regarding health in humanitarian situations.
  • Strengthen existing coordination mechanisms or, if unavailable, create mechanisms in collaboration with national authorities and the World Health Organization, to ensure that the humanitarian response is timely and coordinated and conforms to humanitarian principles and agreedupon standards and benchmarks.
  • Support a multi-sectoral rapid assessment mechanism and format (including priority health information).
  • Ensure that emergency prepardness and response planning includes delivery strategies, resource requirements, plans for supply and re-supply, and a clear delineation of roles and responsibilities of key partners.
  • Develop and maintain an inventory of essential health supplies, including vaccines, cold chain and essential drugs.
  • Identify senior technical staff with health policy experience in emergency and early recovery to strengthen surge capacity.
  • Ensure periodic training of health workers, including community agents, in emergency preparedness and response.
  • Ensure that data on pre-emergency coverage of critical maternal, neonatal and child health interventions is up to date and, if necessary, strengthen and/or establish monitoring, evaluation and tracking systems.
  • Develop appropriate health education and promotion messages at the regional level through community involvement, and ensure availability of, and agreement on, suitable partners for implementing behaviourchange communication activities at the country level.
  • In collaboration with Supply and Logistics, prepare supply plans and distribution strategies based on local capacity to ensure appropriate supplies deliveries. Develop long-term agreements for procurement of essential supplies where these are locally available.
  • Develop the capacity of national stakeholders, at all levels, to respond to emergencies.

Response

  • Support a strong health cluster/inter-agency coordination mechanism (as a cluster partner or lead, as appropriate) to ensure rapid assessments of the health sector and the implementation of an appropriate response to maternal, neonatal and child survival needs.
  • Ensure the rapid provision of a context-appropriate package of services. Typically this includes measles vaccination and distribution of vitamin A, long-lasting insecticide-treated nets and deworming medication, but the actual package and delivery mechanism will depend on the context.
  • Ensure the re-establishment of disrupted essential care services for women and children, including the provision of essential drugs, diagnostics and supplies. Priority essential health services will include:
    1. Treatment of conditions with a high impact on maternal, neonatal and child survival, such as pneumonia, diarrhoea and malaria (where appropriate).
    2. Critical services such as maternal health services, the Expanded Programme on Immunization (EPI) and HIV prevention and treatment services.
    3. Clinical and psychosocial services for victims of sexual violence and/or child abuse.
  • Ensure dissemination of key health education and promotional messages and behaviour-change communication to affected populations, with a focus on available health services, home management, danger signs for common life-threatening conditions (depending on context) and universal health promotion and precautions (e.g., breastfeeding, health-seeking behaviour, safe motherhood, hand washing, hygiene and sanitation).
  • Ensure the supply and distribution of culturally and socio-economically appropriate essential household items to affected populations.
  • Identify and transmit supply inputs to Supply and Logistics.

Early Recovery

  • Ensure that health coordination and action links to recovery and longterm development by supporting national stakeholders and the Early Recovery Cluster/Network in elaborating transition strategies and plans that strengthen local and national ownership, and develop the capacity of both government and civil society, addressing risk reduction.
  • Ensure that early recovery and transition plans incorporate key maternal, neonatal and child survival needs. It is important that these plans link to existing national health strategies (e.g., health systems strengthening plans and health sector reform plans).
  • Provide critical inputs towards re-establishment of routine services, e.g., cold chain for resumption of EPI services.
  • Initiate discussions on the use of the emergency response as a platform for sustainable scale-up of critical maternal, newborn and child health interventions, and utilize opportunities provided by the emergency to review existing strategies and protocols with a view to 'building back better'.
  • Initiate a gap analysis of local and national capacities in health, and ensure integration of capacity strengthening in early recovery and transition plans, with a focus on risk reduction.

Guidelines and Tools

  Commitments
Health Cluster Guide, WHO, 2009 1
Global Health Cluster Orientation Package 1
The Multi Cluster/Sector Initial Rapid Assessment (MIRA) Approach, IASC 2011 1
Communicable Diseases Control in Emergencies (see Sections on Immunizations): A Field Manual, WHO, 2006 2|3
Early Warning Surveillance and Response in Emergencies, Report of Technical Workshop, WHO, 2009 2
Early Warning Surveillance and Response in Emergencies, Report of Technical Workshop, WHO, 2010 2
Malaria Control in Complex Emergencies Handbook, WHO, 2005 2
Epidemic Control for Volunteers, IFRC, 2008 2
Core Capacity Monitoring Framework: Checklist and Indicators for Monitoring Progress in the Development of IHR Core Capacities in States, IHR, 2011 2
Cholera Guidelines, forthcoming, MSF 2
Training Manuals for Cholera Case Management for Clinical Staff and Community Health Workers, forthcoming 2
Acute Diarrhoeal Diseases in Complex Emergencies: Critical Steps, WHO, 2010 2
Inter-agency Field Manual on Reproductive Health in Humanitarian Settings, UNICEF, 2010 2
Inter-agency Minimal Initial Service package (MISP) for Reproductive Health in Crisis Situations, UNICEF, 2009 2
Prevention and Management of Wound Infections, WHO 2
Management of Dead Bodies After Disasters: A Field Manual For First Responders, PAHO, 2006 2
Manual for the Health Care of Children in Humanitarian Emergencies, WHO, 2008 3
Behaviour Change Communications in Emergencies, UNICEF, 2006 4
Facts for Life: Messages for Preparedness and Response, En., Fr., Es., Ar., UNICEF, 2010 4
WHO Outbreak Communication Guidelines, WHO, 2005 4