120124 suggested blueprint for a health in ECHO training

I suggest as a possible blueprint

1. Introduction

Of participants and facilitators to each other

Of the aims and purposes of the gathering

2. Administrative issues to perform appraisals or monitor an issue.

Very short introduction to administrative issues.

The participants move from station to station each station handles one issue that they need to be familiar with and issues one key message that will have to be used in the final exercise.

3. Technical issues to perform appraisals or monitor an issue.

Very short introduction to technical issues.

The participants move from station to station each station handles one issue that they need to be familiar with and issues one key message that will have to be used in the final exercise

4. Case study or simulation or scenario in which they will make one appraisal and one monitoring using the information before.

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For the health stuff:

Think on ECHO health funding administratively as the following "boxes".

Epidemics

Primary health

Secondary health

Primary and secondary health

Community outreach/IEC

Mental health and psychosocial support

Reproductive health

HIV

Medical supplies

Infrastructure/rehabilitation

In which the first 4 and the last 2 have the bulk of the financial volume and the rest have a symbolic and political value.

Departing from the aim of decreasing mortality, mitigating morbidity, alleviating suffering, reducing and managing disability while respecting dignity,

Go though the key areas of intervention:

- For the 6 main causes of mortality in poor tropical settings: diarrhoea, respiratory infection, malaria, tuberculosis, maternal and neonatal causes and injury (be it by purpose or as a result of a disaster).

- The 3 conditions that facilitate diseases: Acute undernutrition, HIV, measles.

- The epidemics that require mass response: cholera, meningitis, yellow fever, pandemic influenza.

- The 2 main causes of disabilities: Mental disorders and physical injury.

Then go trough the structure of the health system: Primary, Secondary, Community outreach/IEC, vertical/horizontal and infrastructure/rehabilitation concerns.

Then go through the 6 blocks of the health systems and the articulation of those 6 blocks with emergency to facilitate transition: Service delivery, health information systems, health financing, human resources, medical supplies and leadership/coordination (rectoria in LAC). Develop with some more detail the contents of service provision: communicable diseases, child illnesses, reproductive/maternal/GO health, non communicable diseases, trauma , mental health and psychosocial support. Make a particular note on non communicable diseases and older age as well as the evolution of the population distribution.

Make the differences between activity, coverage, output and outcome.

List the situations that more frequently lead to crisis, to excess morbimortality and to saturation of local capacities.

Overcrowding and/or displacement.

Poor water, sanitation and hygiene conditions.

Insufficient nutrient intake.

Inadequate shelter.

Epidemics.

Breakdown of vaccination and health services.

Lack of and/or delay in treatment.

High exposure to and/or proliferation of disease vectors.

Warfare among combatants and armed attacks against civilians.

Toxic and radiation poisoning as a consequence of a toxic, chemical or nuclear event.

For the case study, it depends on the context, for LAC I do not suggest a conflict because they are few, I suggest instead a hurricane (because they are many) with floods and shelter and water system destruction, I would not include an epidemic inside the hurricane because natural disasters are rarely related to epidemics and when they are it is not because the disaster but because of population movement and overcrowding, but I will include a high burden of diarrhea and respiratory infection due to water disruptions and lost of shelter. So concentrate on service delivery via primary and secondary health, community outreach, medical supplies, mental health.

             Written in the categories2012