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Transcript of Michelle Dynes, EIS Officer/Epidemiologist, CDC Rachel Idowu, Medical Epidemiologist, CDC Ann...
Michelle Dynes, EIS Officer/Epidemiologist, CDCRachel Idowu, Medical Epidemiologist, CDC
Ann Burton, Senior Public Health Officer, UNHCRDina Jardaneh, Associate Public Health Officer, UNHCR
Maysa Al-Khateeb, Emergency Reproductive Health Officer, UNFPAShible Sahbani, Humanitarian Coordinator, UNFPA
Sathyanarayanan Doraiswamy, Emergency RH Officer, UNHCRBasia Tomczyk, Health Scientist, CDC
Lessons Learned from Reproductive Health Surveillance in Za’atari Refugee Camp —
Jordan, 2013-2014
Center for Global Health
Emergency Response and Recovery Branch
BACKGROUND
Za’atari Refugee Camp Reproductive Health Surveillance
Syrian Refugees Today
http://data.unhcr.org/syrianrefugees/country.php?id=107http://misp.lacrounfpa.org/unfpa/mispcalculator/advocacy/NjE5MTYwOzQwOzI0OzU7ODU%3D
Syrian Refugees Today
http://data.unhcr.org/syrianrefugees/country.php?id=107http://misp.lacrounfpa.org/unfpa/mispcalculator/advocacy/NjE5MTYwOzQwOzI0OzU7ODU%3D
155,647
Syrian Refugees Today
http://data.unhcr.org/syrianrefugees/country.php?id=107http://misp.lacrounfpa.org/unfpa/mispcalculator/advocacy/NjE5MTYwOzQwOzI0OzU7ODU%3D
18,678
155,647
Jordan and Za’atari Refugee Camp – Aug 2013
Jordan and Za’atari Refugee Camp – Aug 2013
More than 520,000 refugees in Jordan Majority of refugees in
urban settings
Jordan and Za’atari Refugee Camp – Aug 2013
More than 520,000 refugees in Jordan Majority of refugees in
urban settings
Over 120,000 Syrian refugees in Za’atari camp 30,504 women aged
15-49 3,660 pregnant women
Photo 7/2013: http://www.mirror.co.uk/news/world-news/syria-refugee-
camp-aerial-pictures-2067144
HEALTH INFORMATION SYSTEM
Za’atari Refugee Camp Reproductive Health Surveillance
UNHCR Health Information System (HIS)
UNHCR Health Information System (HIS)
Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp
settings
UNHCR Health Information System (HIS)
Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp
settings Up to 10 technical sections with three core
pillars
UNHCR Health Information System (HIS)
Standards and
Indicators
Tools and Guidelines
Coordination and
Support
Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp
settings Up to 10 technical sections with three core
pillars
UNHCR Health Information System (HIS)
Standards and
Indicators
Tools and Guidelines
Coordination and
Support
Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp
settings Up to 10 technical sections with three core
pillars
UNHCR Health Information System (HIS)
Standards and
Indicators
Tools and Guidelines
Coordination and
Support
Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp
settings Up to 10 technical sections with three core
pillars
Problem Statement
RH component of the HIS in Za’atari needed improvement
Many contributing factors
Transition & consolidation of comprehensive RH services highlighted need for quality RH data
Delivery Room in Za’atari Camp/UNFPA
EVALUATION DESIGN
Za’atari Refugee Camp Reproductive Health Surveillance
Evaluation Objectives
Evaluation Objectives
Review the RH component of Za’atari HIS
Review national RH HIS and reporting templates to ensure proposed changes reflect national RH
Implement a system for maternal and neonatal mortality audits in Za’atari
Provide technical support and facilitate implementation of RH component of HIS
Develop an action plan to implement the proposed recommendations
Evaluation Objectives
Review the RH component of Za’atari HIS
Review national RH HIS and reporting templates to ensure proposed changes reflect national RH
Implement a system for maternal and neonatal mortality audits in Za’atari
Provide technical support and facilitate implementation of RH component of HIS
Develop an action plan to implement the proposed recommendations
Evaluation Objectives
Review the RH component of Za’atari HIS
Review national RH HIS and reporting templates to ensure proposed changes reflect national RH
Implement a system for maternal and neonatal mortality audits in Za’atari
Provide technical support and facilitate implementation of RH component of HIS
Develop an action plan to implement the proposed recommendations
Evaluation Objectives
Review the RH component of Za’atari HIS
Review national RH HIS and reporting templates to ensure proposed changes reflect national RH
Implement a system for maternal and neonatal mortality audits in Za’atari
Provide technical support and facilitate implementation of RH component of HIS
Develop an action plan to implement the proposed recommendations
Evaluation Objectives
Review the RH component of Za’atari HIS
Review national RH HIS and reporting templates to ensure proposed changes reflect national RH
Implement a system for maternal and neonatal mortality audits in Za’atari
Provide technical support and facilitate implementation of RH component of HIS
Develop an action plan to implement the proposed recommendations
Evaluation Methods
Evaluation Methods
August 18 to September 14, 2013
Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings
Quantitative HIS reproductive health data
Evaluation Methods
August 18 to September 14, 2013
Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings
Quantitative HIS reproductive health data
Evaluation Methods
August 18 to September 14, 2013
Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings
Quantitative HIS reproductive health data
THE FINDINGS
Za’atari Refugee Camp Reproductive Health Surveillance
Multiple Non-traditional Health Actors
Multiple Non-Traditional Health Actors
Varied data
collection methods
High staff turnover
Lack of information sharing
Varied data
collection methods
High staff turnover
Lack of information sharing
Multiple Non-Traditional Health Actors
Varied data
collection methods
High staff turnover
Lack of information sharing
Multiple Non-Traditional Health Actors
Contributed to incomplete & inconsistent
reporting
Varied data
collection methods
High staff turnover
Lack of information sharing
Multiple Non-Traditional Health Actors
Contributed to incomplete & inconsistent
reporting
Reduced data quality
Varied data
collection methods
High staff turnover
Lack of information sharing
Multiple Non-Traditional Health Actors
Data Quality – Weekly HIS Profile Reports
Data Quality:
Data Quality – Weekly HIS Profile Reports
Few health actors reported family planning
(FP) data
Data Quality: Weekly HIS Detailed Reports
Data Quality: Weekly HIS Detailed Reports
No mechanism to monitor
complete postnatal care
(PNC)
Data Quality: Weekly HIS Detailed Reports
No SGBV cases reported
No mechanism to monitor
complete postnatal care
(PNC)
ACTION PLAN
Za’atari Refugee Camp Reproductive Health Surveillance
Health Information System Action Plan
Standardize RH Data
Collection
Improve information Sharing
Encourage timely
submission
Train on registers and user guides
Develop FP register
Development of a RH Tally Sheet
Health Information System Action Plan
Standardize RH Data
Collection
Improve information Sharing
Encourage timely
submission
Train on registers and user guides
Develop FP register
Development of a RH Tally Sheet
Pregnancy Card implementation
Involve CHWs
Health Information System Action Plan
Standardize RH Data
Collection
Improve information Sharing
Encourage timely
submission
Train on registers and user guides
Develop FP register
Development of a RH Tally Sheet
Pregnancy Card implementation
Involve CHWs
Identify a RH Focal Point within each partner
Implement a Mortality Event Review & Response protocol
LESSONS LEARNED
Za’atari Refugee Camp Reproductive Health Surveillance
Lessons Learned
A flexible, systematic approach
to data collection and reporting is
needed
Lessons Learned
Engagement with and training of
health actors on key RH data to be
collected at different phases
A flexible, systematic approach
to data collection and reporting is
needed
Lessons Learned
A flexible, systematic approach
to data collection and reporting is
needed
Agreement on and development of a
standardized approach to RH data collection at global
level
Engagement with and training of
health actors on key RH data to be
collected at different phases
Lessons Learned
A flexible, systematic approach
to data collection and reporting is
needed
Agreement on and development of a
standardized approach to RH data collection at global
level
Using RH registers early in a crisis highlight key
women’s health outcomes and guide
interventions
Engagement with and training of
health actors on key RH data to be
collected at different phases
Lessons Learned
Provider involvement in
development and adoption of tools
enhances commitment and
collaboration
Lessons Learned
Data sharing between services
provided inside and outside the camps
Provider involvement in
development and adoption of tools
enhances commitment and
collaboration
Lessons Learned
Evaluate quality of HIS data early &
work with partners to develop and
implement an action plan
Data sharing between services
provided inside and outside the camps
Provider involvement in
development and adoption of tools
enhances commitment and
collaboration
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
AcknowledgementsUNHCRUNFPAMinistry of Health, Jordan Za’atari Health Actors - GSF, IMS, IRD, JHAS, MDM, MFH, MSF, RMS, Saudi ClinicCDC Syrian refugee population
Center for Global Health
Emergency Response and Recovery Branch