Tools and references for emergency health management
You have to prepare a final report. Your report is the official memory of all your activities, and provides WHO with a global evaluation of the response. It must help you order your experiences and ideas, and help others take action on the basis of what you recommend. Keep the report short, but use Annexes to include all that you feel is important. We suggest the following format.
1. Start with an Executive Summary. Then proceed with:
2. The findings. This part must be as factual as possible. Avoid adjectives and adverbs: all of them, not only the 'unnecessary' ones.....! As a rule of thumb, if you really feel that a certain statement requires an adjective or adverb, think again: maybe it is an opinion of yours rather than a fact, and it should go in the second part of the report, under conclusions and evaluation.
2.1. Give a summary of how the emergency started, and which factors contributed to its evolution. Describe the impact on the environment, economy, infrastructure, population etc. Refer to the Annexes, where you will add maps, charts and even copies of more exhaustive documents (e.g. another Agency's report), in order to illustrate and substantiate your information.
2.2. Summarize your first rapid assessment. Describe the situation as you found it on your arrival in country. Describe the conditions and identify the partners operating in the area. Give a detailed account of health issues (mortality rate, epidemics, nutrition etc.)
2.3. Summarize your initial Master plan. A full copy of it can go in the Annexes. Describe the methods used to bring together and coordinate your partners, the main constraints and how they were tackled.
2.4. Describe the evolution of the emergency - new diseases, the interaction of other natural hazards, e.g. floods, social, political or military changes - and of the response operations. How they were coordinated and implemented. Describe major changes in strategies or procedures. Logistical changes. Obstacles and solutions. List your partners and give objective information on their capacities.
2.5. Describe the systems that WHO set in place. Illustrate the surveillance system, what was done to establish or expand it, the training given; illustrate the catchment area, the indicators, methods of reporting, analyzing and diffusing the information. Describe the communications and the logistics networks, the equipment used, how effective was it, what will be left in place. Were nationals trained to take over?
2.6. Human resources and supplies. Give an estimate of the total resources brought into the emergency, in terms of personnel, expendables and equipment. Illustrate what is left in place for rehabilitation and contingencies. Refer to the Annexes for the relevant lists.
2.7. Funds. Of the total funding received for response, how much was specified for health? How much was used, including funds already earmarked for ongoing projects/programmes etc.? What remains to be used? What remains in the pipeline?
3. The conclusions and the evaluation. This part of the report must reflect your professional opinions. This is the section where adjectives will be useful. Be diplomatic but sincere. You must evaluate the following:
3.1. Your work- Was your mission a success? Qualified or absolute? How much do you feel you achieved of your general objectives? Which lessons have you learnt?
3.2. Health issues and practices- Did you come across some health aspects of the emergency that call for further investigation from the technical divisions at WHO/HQ? In terms of fieldwork, is there the need for special 'emergency' technical protocols?
3.3. WHO country office - Given the country's profile, how can the WHO office better prepare itself for new emergencies? Are there lessons for other country offices?
3.4. Regional Office and HQ - From your initial briefing through to your departure, how can their procedures for emergency response be streamlined or improved?
3.5. International partners, UN and NGOs - How did they do? Were they responsive and cooperative to coordination? What are their strengths and weaknesses?
3.6. National authorities - How the health system has improved from your arrival to departure. How did they respond to international intervention? What can WHO do to strengthen international agreements on emergency health issues?
3.7. National NGOs and other national partners - How did they do? Were they responsive and cooperative to coordination? What are their strengths and weaknesses?
3.8. UN Resident Coordinator - Was he/she familiar with health intervention policies? What assistance did you receive from him/her in relation to the coordination and implementation of the response?
3.9. Donors - How can they respond more efficiently in the future? What do they need in the way of feedback from the field? Was their reaction positive to your coordination? What concerns, if any, did they express?
3.10. Resources - What can be done with the resources delivered and not yet utilized? What about the pending pledges and resources that remain in the pipeline?
4. The recommendations. On the basis of your conclusions, make recommendations. From the experience and insight you have gained, you can facilitate decisions for additional programmes or activities, changes in policies and methods, streamlining of procedures and cuts in costs.
Be clear and practical in your recommendations. Avoid vague statements and wishful thinking. Use verbs indicating activities, not objectives. Use short sentences to indicate actions and who should implement them; suggest timetables; identify partners.
5. The Annexes. The Annexes will include a copy of your terms of reference, more background data on the country and the emergency (e.g. maps, samples of the formats used to collect data and reporting, charts, graphs, lists of personnel, medical equipment and supplies, tables with financial summaries, copies of the most important correspondence, notes for the record, etc.).
Expand the Annexes as much as you have to. Your report is important to WHO. In many ways, it may end up being the principal piece of WHO's institutional memory on the emergency. No detail is too small. Use the Annexes to include anything and everything that you feel is important.