Rapid Assessments

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Rapid Assessments
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Methods of Data Collection
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Examples

• Post-tsunami Aceh
• All sectors
• Ethiopia drought
• Water, health, food security
• Mali and Burkina Faso
• Nutrition, food security
• Darfur
• Water and sanitation
• Post Katrina displaced pop. in Texas

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Who conducts a rapid assessment?

• Individual NGO interested in a particular region
• UN agencies
• Donor agencies (OFDA, etc.)
• Interagency assessments

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Rapid Assessment - Rationale

• Provides objective information essential for
• SETTING IMMEDIATE PRIORITIES
• Implementing health programs
• Evaluating emergency relief
• Identifying health issues for surveys and
  surveillance

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Rapid Assessment - Rationale

• Response without information
• Ad hoc
• Inappropriate
• Ineffective
• Myth of disaster relief
• All aid is good
• Most humanitarian assistance should await
  adequate assessment

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Rapid Assessment in Humanitarian Emergencies

• What information do I need now?
• How will I get it?
• What will I do with it?

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Rapid Assessment in Humanitarian Emergencies
Objectives

• Need to determine
• Is it really an emergency?
• How many persons are affected?
• What are the immediate needs?
• What local resources are available?
• What external resources needed?
• Need to develop a plan of action

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Rapid Assessment in Humanitarian Emergencies

• What would you use the assessment findings for?

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Rapid Assessment in Humanitarian Emergencies Uses

• Set immediate priorities
• Determine what resources are needed (human and
  material)
• Get pipelines moving
• Allow donors to anticipate needs
• Match UN/NGO capacity to situation needs
• Avoid wasted effort and duplication
• Identify essential health information needs

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Key Pre-requisites for a Rapid Health Assessment

• Clear objectives
• Partners agree and understand
• Ability to conduct the assessment
• Staff, logistic support, security, adequate time
• Dissemination plan
• Commitment to follow up

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Rapid Health Assessment - Initial Phase
ofHumanitarian Emergencies

• Information needs
• Number of people affected
• Health status of the affected population
• Immediate priorities
• Water? Food? Shelter? Measles Vaccine?
• Available resources
• Access to health services
• Potential outbreaks measles, cholera,
  dysentery?
• Other problems security?

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Rapid Assessment

• Use standardized methods of data collection and
  reporting
• Often lack of standardization in data collection
• Multiple data collection tools used by various
  agencies
• Different methods of data collection
• SPHERE Project standard indicators
• Health, Nutrition and Watsan clusters
• development of standardized forms

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Rapid Assessment Data Needs in the Emergency
Phase

• Background social, political, economic
• Background health (affected population host)
• Affected population size and demographics
• Vital health information
• Morbidity (affected population host)
• Mortality rates
• Impact on the health system
• Nutritional status
• Access to health services
• Environmental conditions water, shelter,
  sanitation

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Rapid Assessment Data Needs in the Emergency
Phase

• Affected population size and demographics
• Pre-existing data
• Refugee registration systems/census
• NGO/WFP food distribution lists
• OPV coverage estimates
• If no data
• Arial or satellite images
• Visual inspection
• Spatial sampling using GIS
• Do a census?

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Rapid Assessment Data Needs in the Emergency
Phase

• Affected population size and demographics
  (continued)
• Challenges
• Constant movement in out
• Population figures tied to food distribution
• Demographics tied to non food items
• Ethnic tensions
• Local vs. refugee populations discrimination
• Lack of access to count people

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Rapid Assessment Data Needs in the Emergency
Phase

• Background Health Items to look for
• EPI coverage rates
• Previous outbreaks - cholera? dysentery? yellow
  fever? hemorrhagic fever?
• Is area in meningitis belt?
• Patterns of malaria transmission in refugee/host
  population
• Common causes of mortality
• Reported micronutrient deficiency outbreaks?
• Seasonal patterns of floods, rains, cyclones?
• Earthquake zone? Volcanoes?

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Rapid Assessment Data Needs in the Emergency
Phase

• Vital health information Mortality rates
• Crude Mortality Rate (CMR), Under 5 (U5MR)
• Deaths per 10,000 persons per day
• When stable, deaths per 1,000 persons per month
• Age/Sex specific mortality rates
• Cause specific mortality rates
• Case fatality rates measles, cholera
• Access to health services

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Rapid Assessment Data Needs in the Emergency
Phase

• Environment Water
• Quantity of water
• Quality of water
• Accessibility
• Sanitation
• Number of persons per latrine
• Accessibility and acceptability

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Rapid Assessment Data Needs in the Emergency
Phase
Who should be on the team?
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Team composition

• 3 6 persons, including national health
  authorities and affected pop representatives,
  partner UN agencies, NGOs
• Multidisciplinary team with skills in
• Logistics
• Water and sanitation
• Nutrition
• Health care
• Education
• Epidemiology
• Security
• Other expertise depending on situation

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Rapid Health Assessment limitations of process

• Sound methodology versus security and time
  constraints
• Lack of coordination
• Performed too late
• Findings ignored
• Historical data forgotten

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Rapid Health Assessment limitations of (data)

• Deficiencies of Data
• Incomplete, i.e. lack of access
• Not population-based
• Secondary source data i.e. bias
• Limited generalizability / external validity

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Rapid Assessment in Emergencies

• Key elements of a good rapid assessment output
• Timely
• Clear recommendations stating
• Who should do what, when
• State limitations of the data
• Include a plan for surveys and surveillance

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Rapid Health Assessment Summary

• Must be timely
• Multi organizational and multi disciplined
• Address basic needs
• Food
• Water
• Shelter
• Health
• Sanitation
• Set immediate program priorities
• Examine in some degree the health and nutrition
  status of the affected population

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Rapid Health Assessment Summary

• Begin to estimate the size of the effected
  population
• Look at what resources are needed and available
• Anticipate potential outbreaks
• Measles?
• Cholera?
• Dysentery?
• State its limitations
• Include a plan for surveys, surveillance
• Give clear recommendations

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Post Tsunami Rapid Assessment Aceh Indonesia,
January 2005
Coastal village West Aceh before and after the
tsunami
Acknowledgements Satellite images from
DigitalGlobeTM
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Indonesia 01/2005
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Displaced Population Aceh

• Estimated 400,000 IDPs
• Hundreds of settlements with continuous movement
• Little information on health and nutrition
  situation
• Heavy losses to health staff
• Very little information on West Coast

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Inter Agency Rapid Health AssessmentFrom the
Offshore Platform USS Abraham LincolnJanuary
13-20, 2005Rob Holden, WHO
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Mission

• To advance our understanding of the situation so
  we can better define, target and implement
  further immediate life-saving and life-sustaining
  assistance and begin looking at immediate
  recovery needs.
• Develop active programming recommendations for
  agencies for immediate and 30-day actions.

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West Aceh Locations
Zone 1
Gleebruk
Munasah Baroh
Lamno
Suak Buekan
Lho Kruet
Padang Tanjung
Zone 2
Panteku Yun
Patek
Gunung Setui
Fajar
Keude Panga
Zone 3
Jaya
Calang
Suak Kaumude
Zone 4
Keude Teunom
Pandang Banjang
Samatiga
Alue Bilie
Meulaboh
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Questions

• How many communities should be included?
• What sectors should be covered?
• What is the team composition?
• Multiagency?
• What specialties?
• What assessment form to use?
• Where to get the information from?
• How to tie the assessments to action?

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How to get information to guide response?

• Series of rapid assessments
• Multi-agency
• Common assessment tool
• Limited time at each location
• Complicated logistics
• Daily sitrep produced and distributed following
  day

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Assessment Resources

• Team members from MoH and TNI
• Representation from WHO, WFP, UNICEF, UNHCR, OCHA
• Representation from AusAid and USAID, CDC
  Atlanta, IRC/CARDI, Save the Children
• Logistical support, communications, helicopters
  and medical staff from the USS Abraham Lincoln,
  US Navy

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Assessment Methodology

• Liaison with agencies on the ground re who is
  doing what where
• Division of the affected area into four zones
• Each zone assigned an 8-person team, comprising
  experts on public health, Watsan, nutrition, food
  security, primary health care, logistics,
  Indonesian health systems

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West Aceh Field Sites Missions (14 Jan 19 Jan)
14 Jan
Zone 1
15 Jan
Gleebruk
16 Jan
Munasah Baroh
17 Jan
Lamno
18 Jan
19 Jan
Suak Buekan
Helo Landing Zones
Lho Kruet
Padang Tanjung
Zone 2
Panteku Yun
Patek
Gunung Setui
Fajar
Keude Panga
Zone 3
Jaya
Calang
Suak Kaumude
Zone 4
Keude Teunom
Pandang Banjang
Samatiga
Alue Bilie
Meulaboh
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Summary of Assessment Results

• Health
• Water and Sanitation
• Food Security and Distribution
• Shelter and resettlement plans
• Non-food items
• Livelihood
• Logistics

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Water and Sanitation

• Severe shortage of potable water, although
  various supply systems exist (e.g. rivers, wells,
  tanks and bottled water)
• Very poor sanitation systems overall, either
  non-existent or overcrowded
• Soap and detergent in very limited supply for
  bathing and clothes washing
• More operational capacity needed in this sector

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Banda Aceh Water and Sanitation Assessments

• Approx. 150 sites visited between Jan. 24 and
  Feb. 15 in Banda Aceh and Eastern part of Aceh
  Besar
• Majority of IDPs located in host communities
• Water and sanitation conditions better in host
  communities than in settlements

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Results 51 settlements

• 41/51 (80.4) settlements had adequate supplies
  of water
• 18/51 (35.3) met sphere standards of max. 50
  persons per latrine
• 4/51 (9.8) had Indoor residual spraying
• 21/51 (41.2) had fogging at least 1x
• 43/51 (84.3) had adequate jerry cans
• 30/51 (58.8) had adequate soap

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Scoring of priority needs in 37 settlements by
AMT(10 urgent)
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Post Tsunami Rapid Assessment Aceh Indonesia,
January 2005
Banda Aceh City (1), before and after the tsunami
Acknowledgements Satellite images from
DigitalGlobeTM
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Objectives
Riverina Exercise Part IInitial Rapid Assessment

• List health problems common among displaced
  populations.
• Identify sources of health information on persons
  living in displaced persons camps.
• Calculate crude and age-specific mortality rates.
• Use morbidity, mortality, and nutrition data to
  identify and prioritize specific health problems
  in a displaced population and plan interventions.

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Map