Humanitarian Health Action

Purpose statements for panels and sessions

WHO Conference on the Health Aspects of the Tsunami Disaster in Asia


Panel 2.9: Repair and recovery of health systems

Background

National health services, across all tsunami-affected countries, were rapidly overwhelmed and unable to cope using only their own resources to respond to the immediate needs of affected populations. Public health services and health care provision have been severely disrupted.

A further dimension to the health care burden assessment has been the mobility of displaced populations seeking care from functioning facilities in many health service delivery points not within tsunami-affected locations.

After the immediate emergency response phase, a longer-term strategic process of recovery and reconstruction of the health system has started in all tsunami-affected countries, focusing on the needs of affected communities.

In the recovery phase, a “country focus” should be the main approach of the health stakeholders, in making strategic priorities and planning resource allocation for individually affected countries. This would support the national health authorities in protecting their health systems, the health of survivors and other vulnerable people affected by the disaster. Countries receiving assistance should be able, in the future, to lead the management and coordination of health aid programmes through stakeholder partnerships.

A comprehensive assessment of all health system elements (health services, resources generation, health financing and stewardship functions) should be the pre-requisite in developing a strategy and plan of action for the control of health problems due to the disaster and the consequences of the disaster to the health sectors in the “rest of the country”.

A better understanding of staffing losses and an inventory of health care facilities and infrastructure still functioning should be an essential part of the strategic recovery process, as well as mapping of health care service needs in the non tsunami-affected locations.

The following could be identified as the main objectives of key health stakeholders to help governments take the lead in preparing and implementing development strategies to shape the future of their countries:

  • Monitoring public health to provide an early warning of emerging health threats and to enable the timely organization of any necessary response;
  • Timely replacement of lost assets, infrastructure, and supplies that are crucial to meeting additional health needs consequent to the disaster, as well as the reactivation of key previously-available health services;
  • Providing technical expertise to health authorities to enable key gaps to be filled;
  • Establishing and sustaining effective regional, national, and local health coordination arrangements and to enable efficient deployment of assistance resources;
  • Ensuring that adequate up to date coordination, sharing of information on the health situation is available to all local and international stakeholders;
  • Refining health system needs assessments over the coming period, and facilitating early recovery and rehabilitation phases.

Key questions

The panel will examine the role of the main health stakeholders, having in mind how we can better support the existing health care system and how we can better influence and contribute to the overall health reform process in force in the affected countries:

Needs Assessment

  • Have the health system elements (health services, resources generation, health financing and stewardship functions) of “affected” countries, been adequately assessed as a whole in relation to the countries’ health needs and analysis of the economic situation?
  • Has the pre-existing country health reform been taken into consideration in the health system assessment for individual countries?

Coordination

  • Has the health recovery strategy been efficiently coordinated among key stakeholders?
  • Has the health recovery strategy been adequately shaped with a long-term vision and designed to take into consideration “country ownership”, as well as the commitment of governments to policies?

Gap filling

  • Have the available resources been appropriately allocated and utilized to meet the immediate and long-term health needs of the population, taking into consideration the main health and economic country indicators?
  • Has the health recovery strategy been effectively developed with performance indicators and measurable results in the affected areas, in order to readjust the strategy to the outcomes?

Capacity building

  • Has the health recovery strategy been effectively designed to build up national capacities through development of goals and priorities that should be "owned" by the country and based on local stakeholder participation?

What was done well - measured in terms of appropriateness, adequacy, effectiveness, efficiency and connectedness - and what could have and can be done better? How can the lessons learnt be translated into future health guidelines concerning repair and recovery of the health systems of affected countries? Would specific guidelines be useful and, if so, what would these contain, and how could they be put into practice?

The discussion of the above issues in the panel will contribute to the elaboration of the ultimate question for the conference: "How can the international disaster response system be improved to strengthen the health response to disaster?"

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