Health Emergencies in Large Populations - The H.E.L.P. Course

1. Participants are able to assess to what extent the health services in acute and protracted crisis situations meet the needs of the population and identify an appropriate response when there is an imbalance between the needs and the services

1.1. Participants are able to describe an overall health system and what role the formal health care services play

• Health system vs health care services (NB. traditional healers, TBAs, CHWs)

• Health care services as part of the health pyramid /the public health approach: Regulation, promotion, prevention, curative, rehabilitation, palliative

• Health care pyramid: Community, health posts, health centres, level one hospitals, major hospitals/specialized care

• Levels of health care services: Local, district, provincial, central

1.2. Participants are able to describe in which ways key population characteristics and context determine the essential health care services to be provided

• Variability of population health needs based on

  • Population pyramid /demographic pattern

  • Epidemiological pattern /burden of disease

• Impact of the crisis on the needs, e.g. crisis type, crisis stage, population size, population movement

• How the current situation is likely to evolve

1.3. Participants are able to list the essential elements of key health services provided to an affected population

• Essential health care –what does it mean?

  • Key health issues in crisis situations

  • Perspective patient, public sector, private sector (private for profit), NGOs

• Packages of Health Services (minimum, basic, essential, ...)

• Levels of health care services and referral mechanism

• Challenges of priority setting, vertical disease/health programs

• Effect of crisis situations on the capacity of the health care services -> capacity versus needs / imbalance needs and services

1.4. Participants are able to estimate the number of medical consultations, hospitalizations and hospital beds needed for a given population to develop appropriate services

• What is needed and how much

  • Estimate daily requirements for 10'000 persons for

    • Out-patient consultation

    • Hospitalization

    • Number of hospital beds

  • Estimate staff needs to meet the needs for out-patient consultations

1.5. Participants are able to explain the importance of the key components for health care services delivery and how these may vary from one context to another

• Core components (building blocks) of a health system /health facility

  • Health facilities/infrastructure; health work force; equipment; medical & non-medical supplies; financing; service delivery; health information management system; leadership, governance /health facility management; community engagement and communication; coordination

• Humanitarian development nexus

1.6. Participants are able to explain what continuum of care entails and the consequences when this is disrupted

• Define continuum of care

  • Between different levels / types of services

  • Over time

• Risks /negative effects of disruption

1.7. Participants are able to explain the importance of quality and describe the different dimensions of quality of care

• The cost of poor quality care; the cost of quality; quantity vs quality

• Core dimensions of quality in crisis settings

  • Patient safety, effectiveness, patient centeredness and equity

• Quality of care is multi-dimensional

• Ongoing developments in quality of care in humanitarian settings

1.8. Participants are able to understand the steps on whether to support existing services or establish a new health facility

• Determining gaps /imbalances between needs and services

  • Availability of appropriate good quality service

    • Health resources and availability mapping (HeRAMS)

  • Access to available services

• Strategies for intervention (modes of action)

  • Encourage /persuade others to meet their obligations to provide services

  • Support for existing (local) health care services

  • Substitution /direct provision of services

    • Using in-country resources

    • Foreign medical teams; Emergency medical teams

2. Participants are able to examine people's health care seeking behaviour and explain what barriers there may be to access health services –see also module Violence against Health Care

2.1. Participants are able to list barriers to access health services

• AAAQ framework (availability, accessibility, acceptability, quality)