Oxfam's Approach to Humanitarian Emergencies

Public Health Promotion is a planned and systematic effort to enable people to take action to prevent or mitigate disease. It is not possible to provide a plan for setting up a public health promotion program in an emergency as situations will vary greatly.

Guidelines for Public Health Promotion in Emergencies Section 1

Schools can function, religious groups can be mobilized and government structures can be involved in service delivery. Other environmental risk factors may be considered important, such as the threat of landmines or snakes, but continued support to ensure adequate disposal of feces may still be necessary.

Guidelines for Public Health Promotion in Emergencies

During the initial assessment period, try to identify the camp or community organization and any leaders. Field workers may already exist and their initial training simply needs to be supplemented. Try to identify them.

Guidelines for Public Health Promotion in Emergencies

Assessment data is meaningless without subsequent analysis of the information and the setting of priorities. In the camping situation it is often easier to keep track of the amount of water being distributed and to assume that this will give an indication of the amount of water actually being used.

Guidelines for Public Health Promotion in Emergencies

All too often, this is an activity that is seen as the sole task of public health promoters. The initial information obtained from the assessment will provide some useful baseline data, but it cannot be assumed that it will be sufficient to measure the success of the program.

Rapid Assessment

It will be necessary to continue to collect basic data and to try to do this in a structured way. In an emergency situation where time is limited, it may only be possible to obtain data that is representative of the situation rather than data that is statistically valid.

Baseline Data

Evaluation will have to rely heavily on people's perception of the impact and on the evaluation of the combined response of agencies. However, the nature of public health promotion is such that more data is collected with each interaction with groups or individuals, and this should all be entered into a separate assessment and baseline data report to facilitate subsequent monitoring and evaluation.

Further Analysis

Guidelines for Public Health Promotion in Emergencies

The team identified a need for monitoring and evaluation, but did not feel it had the time to establish the necessary baseline data collection. One team member attempted to design a more structured baseline data collection that included focus group discussions, key informant interviews, structured observations, water point observations and.

Guidelines for Public Health Promotion in Emergencies

If other methods are used and checked, a greater reliability of the data can be assumed. Not applicable at this stage This method can be used to produce a large number of observations on specific issues such as the number of school children who wash their hands after using the toilet.

Rapid Assessment Baseline Data Collection Monitoring Assessment

Guidelines for Public Health Promotion in Emergencies

How have you ensured women's safety? bathrooms away from the camp or without adequate lighting may make women more open to sexual violence). How have you ensured women's privacy? toilets must be separate from men and have a simple lock on the door).

Guidelines for Public Health Promotion in Emergencies

Logical frameworks are now more commonly used and it is a useful exercise to work with other team members to draft a large framework and fill in the specific details of the project (see the resources section for example logical frameworks). It should be remembered that in many areas of the world crisis has become a way of life and increasing people's capacity to cope with subsequent crises should be one of the objectives of any crisis.

Guidelines for Public Health Promotion in Emergencies

Identify and start training 10 child facilitators to promote hygiene among young children using play and other participatory methods within 3 weeks. Identify and start training 80 additional volunteers (2 per 1000 population) to promote hygiene within the community through group discussions, home visits, use of songs, plays, puppets and demonstrations etc.

Action &

Guidelines for Public Health Promotion in Emergencies

It will be helpful if short meetings are organized during the campaign to assess any major issues. The number of facilitators will depend on the area to be covered, its accessibility and the urgency of the situation.

Guidelines for Public Health Promotion in Emergencies Section 4

However, they should not be used as a substitute for interaction and discussion in an emergency context where quick results are needed. In the camps in Freetown, Sierra Leone pots were distributed to every family with children under five - one pot for every two children.

Guidelines for Public Health Promotion in Emergencies Section 4

Resolving issues with community members is also an important aspect of the public health promotion team's work. One of the leaders was quoted as saying that “our practices have become visible to all – now we need to talk.”

Guidelines for Public Health Promotion in Emergencies Section 4

Ensure people have key information to prevent water and sanitation-related diseases: focus only on those that pose the most serious threat (include knowledge of ORT if not done by other agencies). Recruit and train campaign workers to provide key information to people in a cholera or malaria control campaign over a period of one to two weeks.

Guidelines for Public Health Promotion in Emergencies

It is also useful to consult with community members when trying to ascertain morbidity and mortality. Timelines, seasonal calendars or matrices (see Participatory Learning and Action: trainer's guide) can be useful ways to start discussions about mortality and morbidity.

Guidelines for Public Health Promotion in Emergencies

Mortality and morbidity rates from water- and sanitation-related diseases (eg malaria, diarrhoea, dysentery) divided by gender (if concerned) and age. Proportion of mothers who know how to make ORT and how to use it Sanitation.

Guidelines for Public Health Promotion in Emergencies

If nutrition surveys are conducted, some questions related to general public health may be included in the questionnaire. Information for monitoring can be collected by school children as part of learning activities.

Guidelines for Public Health Promotion in Emergencies

Encourage the use of ash as an alternative to soap, organize soap distribution Start child to child activities. Continue malaria education and discussion groups. Include malaria in child-to-child activities Families shop.

Guidelines for Public Health Promotion in Emergencies

Impact on people’s lives

It should be remembered that sustainability may not necessarily be the main objective of emergency work and the impact on people's lives provides the most important indicator of impact. One of the main indicators for determining the impact on people's lives in emergencies is the rate of mortality or morbidity.

Guidelines for Public Health Promotion in Emergencies Are more people using the protected water source for their drinking water now or do

Beneficiary Participation
Sustainability
Impact on Gender Equity
Impact On Policy And Practice

Important

Guidelines for Public Health Promotion in Emergencies

If household observation surveys are conducted, observers will need careful supervision and monitoring to ensure accurate completion of forms to avoid observer bias and inconsistency. If promotional material is being developed, remember that this can be a good opportunity to portray women in non-traditional roles.

Guidelines for Public Health Promotion in Emergencies

People will not automatically take responsibility for keeping the system functional in the longer term and may think that this is taken care of by the relevant agency. Are women involved as much as possible in the initial discussions about the proposed project?

Resources

Guidelines for Public Health Promotion in Emergencies

Are people willing to use latrines, defecation fields, trenches, etc., e.g. is it safe for women in the dark, and are they safe/easy to use for children). What is the total mortality rate (crude mortality rate – CMR) – expressed as deaths per 10,000 inhabitants per day. Any evidence of under- or over-reporting?).

Guidelines for Public Health Promotion in Emergencies

What does the family use to store drinking water in?
Is this water covered?
Is the water container clean?
Does the family have a latrine?
Are there handwashing facilities?
Do all members of the family including children use the latrine?
Is there a problem with
Did you see the child 0-8yrs (give age_____) defaecate during the
Where did the child defaecate?
What happened to the Stools?
After cleaning the child’s bottom did the person,

Start in the center of the settlement or camp and select every other house along the transect. Remember that this is not valid research, but a representation of the situation, so no conclusions can be drawn from these results alone.

Guidelines for Public Health Promotion in Emergencies

What are the available water sources and are they protected?
Who collects water?
What utensils are used for fetching water?
What activities take place at or near the water source?
How long do people have to queue for water?
How long does it take to fetch water?
Is water available continuously or at specific times only – give details
Is there adequate drainage at water points?
Is there evidence of faecal contamination?
What is the contamination observed?
Where is it observed a) compounds
How many houses / shelters have latrines?
Are the latrines clean? If not are there
Are there any hand washing facilities near to the latrine?
Are there public toilets in public places?

Introduce yourself to the group and explain very clearly the purpose of the exercise and that you hope everyone will learn from the session. The recorder must try to make as many notes as possible or if a tape recorder is available and with the permission of the participants you may record them.

Guidelines for Public Health Promotion in Emergencies

Pictures or photographs can be used to depict each activity or location on the two axes. If people are not used to using pocket cards, it is better to simplify the process and vote on each activity in turn until people get used to it.

Guidelines for Public Health Promotion in Emergencies

Men and women do not use the same toilets and it is forbidden for a man to see his mother-in-law going to the toilet. A child with a fever is first taken to the traditional healer and then, if there is no improvement, to the clinic.

Guidelines for Public Health Promotion in Emergencies

Overview of Public Health
Programme Objectives or Logframe
Monitoring indicators and status form (see appendix 11)
Gender and Representation
PHP process indicators and status
Training and promotional activities carried out and planned (including distributions)
Materials developed
Request for support or advice from OH 9.0 Issues & recommendations (final report)

It is a common belief among men and women that diarrhea and fever are caused by malevolent ancestors who summon the spirits to harm the family. If hand-pumped water is not available, people usually use the water from unprotected wells, provided it is not too salty.

Guidelines for Public Health Promotion in Emergencies

Increase in the number of families digging their own latrines Hand washing facilities next to the latrine. Increase in the number of risk reduction initiatives taken by community groups Increase in the number of educated.

Guidelines for Public Health Promotion in Emergencies

Restrooms are safe and private, especially for women. At least one water point per 250 people is provided. 15 liters of water are collected per person per day. The maximum distance from any shelter to a water point is 500 meters.

All sections of the

Public water points are sufficiently close to shelters to meet the minimum water requirement (Sphere water supply standard 1).

All facilities and

Guidelines for Public Health Promotion in Emergencies

Facilitate the community to decide on long-term sanitation options within 4 weeks (target 20 people per toilet). the number of bathrooms built or designated areas .. the percentage of men and women consulted for the design of new bathrooms. project data, observational focus group discussions and community meetings. obtain agreement and support from local administration and community representatives on the acceptability of defecation areas or public toilets ACTIVITY 3. ACTIVITY 12 ensure ongoing project assessment, planning and monitoring (update the registry framework as necessary). the quality and quantity of data received, . project data assumes that the situation remains stable and access to refugees remains possible.

Guidelines for Public Health Promotion in Emergencies

Within three weeks, identify and start training 10 child facilitators to promote hygiene in young children using games and similar methods. Contribute to reducing the incidence and severity of malaria and dengue fever in high-risk groups.

All sections of the

Guidelines for Public Health Promotion in Emergencies

To ensure that public toilets are kept clean after use (cleaning should be done frequently during the day). Provide information to toilet users on the importance of flushing all faeces in the camp (including that of young children and infants) and on the necessity of digging the family toilet.

Guidelines for Public Health Promotion in Emergencies

3:00 am - 4:00 pm Exploring the use of songs, stories, role plays and puppets to learn more about diarrhea and its prevention.

Guidelines for Public Health Promotion in Emergencies

BREASTFEEDING
FEEDING OTHER SOLID FOODS

After the works are completed, the community will immediately assume responsibility for the long-term maintenance of the wells and pumps. The community will identify two suitable persons (one male and one female) who will be trained in basic maintenance of hand pumps and well.