Humanitarian Health Action

Managing WHO Humanitarian Response in the Field - 6 Defining Objectives and preparing an Action Plan

6.1 Defining objectives

An objective is the desired state that it is intended to achieve – the desired outcome. Objectives are defined at different levels – overall objectives (or “goals”) of the emergency programme and specific objectives (or “purposes”) of individual WHO projects that contribute to achieving the higher goals.

Defining objectives is a key element of step 2 in the response process chart in Figure 2b (in section 2.2). It should be done jointly, collaboratively by WHO, the MoH and other main health partners, whenever possible.

Clarity and agreement on objectives are essential for coherent, coordinated humanitarian health action. They must be understood by all stakeholders and easy to explain. Achieving consensus on objectives is a key sign of leadership and coordination.

2/3. Health sector response plan/WHO action plan:

  • Definition of overall objectives/goals
  • Analysis of response options; selection of strategies
  • Health sector response plan/WHO action plan

Guiding principles

Objectives should be defined in relation to the priority health problems and risks identified in the situation analysis and within the overall framework of reducing excess mortality, morbidity, malnutrition and disability and restoring the delivery and access to health care. They must address the main causes of death and illness and the major constraints to delivery of and access to health care.

Objectives may include improving information as well as achieving direct health outcomes. While many will concern aspects that are the responsibility of the MoH (and the Health Cluster/sector coordination group), some may relate to aspects that are the responsibility of other ministries (and other cluster/sector coordination groups).

Objectives must be “SMART” – specific, measurable, accurate, realistic and time-bound (e.g. “the risk of diarrhoea reduced by 50% in the target population in 6 months”). They must:

  • address coherently the priority problems and risks identified in assessments;
  • be tailored for specific phases of the response;
  • differentiate among men and women, girls and boys, when appropriate; and
  • take account of protection and human rights issues, the impact of HIV/AIDS, security conditions and any limitations on access.

Objectives may need to be reviewed and refined if there are significant changes in the situation or the resources available (including the number, interests and competencies of the health actors present), or when new information becomes available from assessment or monitoring activities.

Initially the focus will be on ensuring that life-threatening humanitarian needs are met, while always looking for opportunities to promote recovery and rebuild systems. As soon as life-threatening needs are met, the focus should shift progressively to re-building national systems and capacities while ensuring that any remaining humanitarian needs are met.

N.B. Assessment determines the effects of the crisis and provides conclusions in terms of intervention priorities in rank order. However, those overall sector priorities may NOT remain as WHO’s organizational priorities as other stakeholders address selected needs according to their comparative advantages. WHO must be continually aware of overall priorities and unmet needs, and respond to the latter.

Panel 6-1 Some factors to consider when formulating objectives
• the hazards, or threats, that need tackling, e.g. malnutrition, measles and/or malaria,
• the vulnerabilities that need reducing, e.g. people living in crowded temporary settlements/accommodation,
• the capacities that need strengthening, e.g. health posts at community level/in camps,
• the constraints that need addressing, e.g. military insecurity,
• the expectations that must be met. (The policies and values of the various stakeholders that will affect the evolution of the overall situation and the implementation of activities.)

What to do – key management actions

First steps – during the first few days
  • Where an inter-agency/health-sector contingency plan exists for the type of crisis concerned, review the objectives envisaged in that plan and adjust them to the current initial working scenario.
  • Where no relevant contingency plan exists, develop initial objectives from scratch based on the initial working scenario.
  • Ensure that the initial objectives defined for the first few weeks of response are realistic and focus on life-threatening humanitarian needs while capitalizing on any opportunities that may exist to initiate recovery straight away.
During the emergency phase/first month
  • Elaborate objectives for the coming 6 to 12 months on the basis of the initial rapid assessment and as new information becomes available. Include both continuing humanitarian response and a progressively increasing focus on recovery.
Once the situation has stabilized/beyond the first month
  • Keep the defined objectives clearly in view, and under review. During periodic progress reviews, check whether the defined objectives are still appropriate and realistic. Revise/refine them if and when necessary in agreement with all concerned stakeholders.

Tools and other guidance

SOP 13.1, section 4.

Annex C1 Core-functions analytical framework which shows how the core functions listed in section 1.4 may be used as a framework for analysis when developing objectives and an action plan.

Annex C5, Key health services and functions provides a list that may also help in putting together overall objectives and a health sector response/action plan.