|Guidelines for HIV Interventions in Emergency Settings (UNAIDS - UNHCR - WHO, 1996, 59 p.)|
In the acute phase of an emergency there is no time for a detailed situation analysis, and relief workers must be prepared to work on the basis of assumptions. However, certain sources of information can and should be tapped to ensure that the relief operation is as relevant as possible to the situation on the ground. HIV prevalence data and country profiles are available from the Joint United Nations Programme on AIDS (UNAIDS) and elsewhere. As discussed before, this will give an idea of the magnitude of the HIV threat and which population subgroups are especially vulnerable to infection. It is an important element in decision-making and setting priorities.
Information on the size of the population affected will be available from national governments in some cases, and from agencies such as UNHCR if refugees are involved. For the purposes of HIV interventions, the gender and age make-up of the affected population is important.
These details are rarely available early on, and opportunities should be identified, as a matter of urgency, for gathering such information during routine emergency relief activities, such as registering people for food distribution, visiting refugee camps, or providing emergency medical care.
During the immediate post-acute phase of an emergency, a health information system (HIS) coordinator and team for the emergency should be named, either specifically for HIV/AIDS/STD aspects of the emergency, in which case the HIS team should be under the STD/AIDS coordinator, or for all HIS needs for the emergency- under the overall coordinator for the emergency. The following are the minimum needs assessments recommended to be carried out:
· Monitoring of HIV and VDRL/RPR sero-prevalence in donated blood for transfusion.
· Monitoring of VDRL/RPR sero-prevalence in pregnant women attending prenatal care.
· Monitoring of reported new cases of: (a) active tuberculosis; (b) male urethral discharge; (c) vaginal discharge; (d) genital ulcers, in the populations affected by the emergency.
· Registration of all persons directly affected by the emergency, recording of age group, sex, language spoken, by camp and/or emergency area.
· Census of all agencies or groups (health ministry; national NGO; bilaterals; multilaterals; international NGOs; multilaterals) providing health services, by type of service offered.
· Site visits to camps or areas affected, to qualitatively assess: accessibility; fragility of camp or area; nature and extent of potential HIV/STD-associated risk behaviours/practices.
· Monitoring of condom, HIV/syphilis test kit availability in health facilities.
· Monitoring of condom, HIV or VDRL/RPR test kit, disposable needle, and ciproflaxin stocks available in the emergency area.
· Annual surveys of HIV sero-prevalence in pregnant women attending prenatal care.
· Prevention indicator surveys, the initial round, 12 months following the initiation of the above-mentioned points and subsequent rounds every 2-3 years, depending on the stability of the camp or area affected, and/or the duration of the emergency.
Detailed instructions for undertaking needs assessment using continuous and discontinuous data are provided in Appendix 6.