![]() | Handbook for Emergencies - Second Edition (UNHCR, 1999, 414 p.) |
![]() | ![]() | 14. Health |
Annex 1 - Health Information System
In the early stages of an emergency it is essential to collect information on a weekly or monthly basis for the following tables:
Table Number |
Table Description |
1 |
Demographic information |
2.1 A and B, 2.2 |
Crude Mortality Rate and Under five years old Mortality
Rate |
3.1 |
Morbidity Incidence |
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Collection of the information required for the other tables should be progressively introduced as the situation stabilizes.
In order to detect problems and to monitor the impact of any health programme, it is necessary to collect information over time so as to follow trends. The tables below are designed to allow tabulation of information on a weekly or monthly basis. Graphical presentation of the same information will make it easier to detect trends. The tables may need to be adjusted to reflect the needs of actual situations.
1. Demographic Information
Table 1 - Population
Camp/area |
Male |
Female |
Male |
Female |
Total |
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Total |
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Sources of demographic information: registration Estimate
Government
Other
% of total population which is under 5 =
% of total population which is female =
Note: demographic information does not necessarily have to be reported in a table format. The denominator used for calculation of rates could differ from the official working figure and this should be clarified.
2. Mortality
2.1 Mortality rates
Mortality rates (segregated by age and sex) should be given per 10,000 per day
A. Crude Mortality Rate: CMR
Table 2.1 A
Camp/area |
Male |
Female |
Total | |||
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Number |
Death |
Number of |
Death |
Number of |
Death |
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Total |
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B. Under five years old mortality rates (U-5 MR)
Table 2.1 B
Camp/area |
Male |
Female |
Total | |||
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Number |
Death |
Number of |
Death |
Number of |
Death |
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Total |
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Female / Male ratio:
A graph line (to show trends) for CMR and U-5 MR could be attached.
2.2 Cause-specific mortality
Tables 2.2 (2.2 A for total population and 2.2 B for under-five population).
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Male |
Female |
Total | |||
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Number |
% of the total |
Number |
% of the total |
Number |
% of the total |
Malaria |
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Pneumonia |
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Watery |
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Bloody |
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Measles |
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Meningitis |
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Cholera |
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Maternal |
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Peri/neo |
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Malnutrition |
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Total |
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100% |
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100% |
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100% |
From table 2.2 A and 2.2 B, pie charts could be attached to the report.
The list of diseases is provided as an indication.
Comments on mortality:
3. Morbidity
3.1 Incidence (Number of new cases per 1,000 of the population for the period)
Tables 3.1 (3.1A for total population and 3.1B for under-five population).
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Male |
Female |
Total |
Malaria |
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Pneumonia |
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Watery diarrhoea |
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Bloody diarrhoea |
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Measles |
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Meningitis |
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STDs |
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The list of diseases is provided as an indication.
3.2 Out-Patient Department (OPD) consultations
Table 3.2 Number of consultations per refugee per year.*
Camp Names |
Male |
Female |
Total |
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Average |
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* from the total number of OPD consultations per camp, extrapolate to define the number of consultations per refugee per year. As an example: 10,000 consultations in one month in a camp of 30,000. 10,000 × 12 = 120,000 / 30,000 = 4 consultations/refugee/year.
Comments on morbidity:
4. Nutrition
4.1 Supplementary Feeding Programme Monthly Report
This table is contained in Annex 4 of chapter 15 on nutrition.
4.2 Therapeutic Feeding Programme Monthly Report
This table is contained in Annex 5 of the chapter 15 on nutrition.
4.3 Food basket monitoring
See chapter 15 on food and nutrition. If undertaken, please specify by whom and the results.
Comments on nutrition:
5. In-Patients Department (IPD) Activities
5.1 Activities
Table 5.1 (per week or month)
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Hospital Name |
Hospital Name |
Hospital Name |
A. No. of patients end |
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B. No of patients |
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C. No. of patients end |
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D. No. Discharged |
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D.1 authorized |
% |
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D.2 unauthorized |
% |
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D.3 deaths |
% |
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D.4 transferred |
% |
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No. of beds |
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Average length |
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Occupancy rate |
% |
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5.2 Main Causes of discharge/deaths in IPDs
Table 5.2 (per week or month).
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Hospital Name: |
Hospital Name: |
Hospital Name: | |||
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Number |
Number |
Number |
Number |
Number |
Number |
Malaria |
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Pneumonia |
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Watery |
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Bloody |
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Meningitis |
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Measles |
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Comments on IPDs:
6. Referral System
6.1 Total number of patients transferred for admission and where:
6.2 Causes of transfer
Table 6.2
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Camp Name: |
Camp Name: |
Camp Name: | |||
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Number |
% of the |
Number |
% of the |
Number |
% of the |
Obstetrics |
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Surgery |
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Paediatrics |
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Internal |
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Blood |
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Total |
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Comments:
7. Main Health Programmes
7.1
Reproductive Health
7.1.1 Safe motherhood
a. Deliveries: Birth
Table 7.1.1
Camp names |
Number |
Crude Birth Rate* |
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Total A: |
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· a1: total # and % of birth in health centre or hospital:
· a2: total # and % of birth assisted by a Trained Birth Attendant (but outside health centre or hospital):
· a3: total # and % of other births (i.e. A - (a1 + a2):
· total number and % of complicated deliveries:
· total # of cases of neonatal tetanus:
· total # and % of deliveries with adequate Tetanus Toxoid (TT) coverage:
b. Ante-natal care (ANC)
· total # of expected pregnancies per year:
· total # of new ANC consultations (last 3 months) and % compared to expected:
· % of women with three ANC visits at delivery:
· are supplements given to pregnant women? specify criteria and supplements provided:
· RPR test (syphilis test): % of positive tests:
c. Other information
· maternal mortality: # and incidence per 100,000 live birth per year:
· Peri/neonatal mortality: # and incidence per 1,000 live birth per year:
· # of abortions and % per number of pregnancies:
· low birth weight (below 2.5 kg): provide # and percentage per total number of births:
· # and percentage of total number of births having a post-natal consultation:
7.1.2 Sexual and gender based violence
· # of cases of sexual and gender based violence per month (incidence per 10,000):
· is there any special programme for Female Genital Mutilation (where prevalent)? if yes, give brief description:
7.1.3 STDs including HIV / AIDS
· enforcement of universal precautions:
· % of blood tested for HIV before transfusion:
· % of HIV positive among blood tested:
· distribution of condoms, # and percentage of acceptance:
7.1.4 Family Planning (every three months)
· number of new acceptors in last three months, per method:
· total # and % of acceptors per method:
7.1.5 Adolescents
Is there any special programme for adolescents? if yes, give a brief description:
Comments on reproductive health:
7.2 Extended Programme of Immunizations (EPI)
· measles vaccination coverage:
· other antigens coverage:
· are there any vaccine preventable diseases prevalent in the camps?:
· comments:
7.3 Tuberculosis (every three months and not usually during the emergency phase)
· expected number of new cases per year (i.e. prevalence in country of origin):
· treatment protocols:
Table 7.3
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January-March |
April-June |
July-September |
October-Dec. |
A. No. under treatment |
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B. No. of new cases |
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C. No. of discharged |
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C.1 cured |
% |
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C.2 defaulters |
% |
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C.3 deaths |
% |
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C.4 transferred |
% |
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Total at end of period: |
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7.4 Cholera/Meningitis/Hepatitis/Micronutrients deficiencies etc.
On daily, weekly and/or monthly basis: number of cases, number of deaths and attack rate (cumulative) and Case Fatality Rate (cumulative). Graphic representation could be attached to the report.
7.5 Mental health
Provide a description of the mental health programme.
7.6 Training activities
Provide a description of training activities which have taken place during the reporting period: type of training, by whom, to whom, etc.
7.7 Laboratory activities
8. Information on other vital sectors
· availability of potable water: # litres per person per day
· availability of functioning latrines per # of persons
· % of population with adequate shelter
· quantity of soap available per person per month
· specify vector control activities
Annex 2 - Possible organisation of health services in a major emergency Number of births in a year
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Unit/Location |
Level |
Health staff |
Outline of major responsibilities |
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· Health Coordinating
Committee |
Capital/national level |
· UNHCR Health Coordinator
or |
· Planning and monitoring
pro- |
3rd level |
Regional/district Hospital |
Regional or district level |
· If necessary: say, 1
doctor, |
· Complicated obstetric cases
and |
2nd level |
Health Centre (with limited beds |
Each refugee settlement |
· As guidance: 2 doctors,
6-8 |
· Supervision of settlement
health |
1st level |
1 Health Post or clinic |
Section level approximately |
· As guidance, 1 nurse
(from |
· Section level services, both
preventative and basic curative care |
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The community |
Outreach services (organized by |
· Refugee Community
Health |
· Identification of public
and |