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Public Health Situation Analysis (PHSA) – Long form

[Country name]

Type of emergency (insert humanitarian icons)

Main health threats

UN Level

Security Level(s) INFORM Index2019(Rank:)

Location Level

WHO INTERNAL/EXTERNAL VERSION (DELETE AS APPROPRIATE)Initiated by: Country Office □ Regional Office □ HQ □

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Executive Summary

This public health risk assessment aims to provide health sector partners, including professionals of local and national authorities, nongovernmental organizations (NGOs), donor agencies and United Nations agencies currently working with populations affected by the emergency, with up-to-date technical guidance on the major public health threats. The topic areas addressed are selected on the basis of the burden of morbidity, mortality and potential for increased burden of disease in the affected areas.

Acronyms and abbreviationsExample

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EPI Expanded Programme on Immunization

ContentsExecutive Summary...............................................................................................................2

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Acronyms and abbreviations..................................................................................................3Preface...................................................................................................................................61. Summary of the crisis......................................................................................................6

i. Key features................................................................................................................6ii. Humanitarian profile....................................................................................................6iii. People in need of health services................................................................................6

2. Health status and threats.................................................................................................6i. Population mortality....................................................................................................6ii. Vaccination coverage..................................................................................................7iii. Priority health threats..................................................................................................7

Sexual and reproductive health.......................................................................................8Malnutrition and child health...........................................................................................8Endemic infectious diseases............................................................................................8Epidemic-prone diseases.................................................................................................8Tuberculosis and HIV......................................................................................................8Non-communicable diseases.........................................................................................8Trauma............................................................................................................................8Mental health..................................................................................................................9Psychosocial support issues...........................................................................................9Health Determinants........................................................................................................9Water, sanitation and hygiene (WASH)............................................................................9Food insecurity.................................................................................................................9Shelter.............................................................................................................................9Security............................................................................................................................9Other determinants..........................................................................................................9

iv. Surveillance/early warning, alert and response capacity.............................................93. Health system needs.......................................................................................................9

i. Local health system disruptions..................................................................................9Disruption of key health system components................................................................10Disrupted management.................................................................................................10Reduction in financing...................................................................................................10Inability of non-state providers to maintain services.....................................................10Disruption to supply chain (including pharmaceuticals).................................................11Degraded alert and response.........................................................................................11Migration of human resources for health.......................................................................11Damage to health facilities............................................................................................11Attacks against health...................................................................................................11

4. Humanitarian health response.......................................................................................11i. Health response organization....................................................................................11ii. Availability / functionality of humanitarian health resources.....................................11

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Facilities data (e.g., HeRAMS)........................................................................................114Ws................................................................................................................................11

iii. Humanitarian health system performance................................................................11Utilisation of services.....................................................................................................11Quality of humanitarian health services.........................................................................11

5. Information gaps............................................................................................................116. Additional Resources......................................................................................................12

Key documents.................................................................................................................12Health cluster contacts and report contributors................................................................12

PrefacePublic health threats represent a significant challenge to those providing health-care services in a crisis. The health issues and risk factors addressed in this document have been selected on the basis of the known burden of disease in this country, crisis-emergent health issues, and their potential impact on morbidity, mortality, response and recovery. It

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is hoped that this PHSA will facilitate the coordination of activities among all agencies working with the populations affected by the crisis. The document contains a short summary of the crisis, health status of and threats to the affected population, health system needs, humanitarian health response, and information gaps. This document presents the best available data at the time of publication, and may be updated, as needed.

1. Summary of the crisisi. Key featuresLocation (country, region): Start date of crisis: Typology: Brief description of event:Operational constraints:

ii. Humanitarian profileAffected population: Population in need of humanitarian health assistance: Deaths: Injuries: Number of IDPs: Returnees: Refugees:

iii. People in need of health services

2. Health status and threats

i. Population mortality

ii. Vaccination coverage

iii. Priority health threats

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Table 1 summarises the current analysis of the magnitude (in terms of excess morbidity and mortality) of different health problems impacting the crisis-affected population, grouped into major disease types. Changes in the projected magnitude of these problems are also shown: these assume that the humanitarian health response (availability, coverage, quality) remains unchanged from its current status. Table 1a covers expected physical health issues, and Table 1b covers acute psychological distress and chronic mental health problems. Table 1a. Magnitude1 of expected physical health threats and their expected evolution over time2.

Health problemMonth(s), starting now

1 2 3-6 6-12Worse outcomes in:Sexual healthReproductive healthWorsening: MalnutritionChild healthIncreased burden of endemic infectious diseases (Please specify)(e.g. Malaria)

Risk of epidemics (Please specify)(e.g. Cholera/acute watery diarrhoea)

Increased burden of:HIVTBIncreased NCD burdenTrauma

1 Red: Could result in high levels of excess mortality/morbidity. Orange: Could result in considerable levels of excess mortality/morbidity. Yellow: Could make a minor contribution to excess mortality/morbidity. Green: Will very probably not result in any excess mortality/morbidity. Grey: No plausible assessment can be made at this time. 2Changes in risk over time shows the expected progression after an acute onset emergency, or predicable seasonality of morbidity.Sexual and reproductive health

Malnutrition and child healthMalnutrition

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Child healthAcute respiratory infections

Anaemia

Breastfeeding

Endemic infectious diseases

Epidemic-prone diseases

Tuberculosis and HIVTuberculosisHIV

Non-communicable diseasesChronic diseasesEnvironmental health and technological hazards

TraumaCrisis-attributable injuries

Recent attacks have included as follows:

ViolenceAgainst children

Gender-based violence

Table 2b. Magnitude1 of expected acute psychological distress and chronic mental health problems and their expected evolution over time.

Psychological distress and

chronic mental health

Month(s), starting now

1 2 3-6 6-12

Acute psychological distressExacerbation of chronic mental

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Psychological distress and

chronic mental

Month(s), starting now1 2 3-6 6-12

health problems1Red: Could result in high levels of excess mental health/psychosocial support problems. Orange: Could result in considerable levels of excess mental health/psychosocial support problems. Yellow: Could make a minor contribution to excess mental health/psychosocial support problems. Green: Will very probably not result in any excess mental health/psychosocial support problems. Grey: No plausible assessment can be made at this time.

Mental health

Psychosocial support issues

Health DeterminantsWater, sanitation and hygiene (WASH)

Food insecurity

Shelter

Security

Other determinants

iv. Surveillance/early warning, alert and response capacity

3. Health system needs

i. Local health system disruptionsDisruption of key health system componentsVarious disruptions to the local health system continue to affect delivery of preventive and curative health services. These are summarised in Error: Reference source not found2.

Table 2. Overview of disruptions to key health system components.

DisruptionMonth(s), starting now

1 2 3-6 6-12

Disrupted managementReduction in financing

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DisruptionMonth(s), starting now

1 2 3-6 6-12Inability of non-state providers to maintain servicesDisruption to supply chain (including pharmaceuticals)Degraded alert and responseMigration of human resources for healthDamage to health facilitiesAttacks against healthAccess to healthcare

1Red: The majority of the health system feature / health service has been or could be rendered non-functional. Most people / patients do not have access to healthcare. A major reduction in health service coverage or quality could occur. Orange: A substantial minority of the health system feature / health service has been or could be rendered non-functional. A substantial minority of people / patients do not have access to healthcare. A moderate reduction in health service coverage or quality could occur. Yellow: A small minority of the health system feature / health service has been or could be rendered non-functional. A small minority of people / patients do not have access to healthcare. A small reduction in health service coverage or quality could occur. Green: The vast majority or entirety of the health system feature / health service is very probably still as functional as before the crisis. No risk factors for reduction in health service coverage or quality have been identified. Grey: No plausible assessment can be made at this time.

Disrupted management

Reduction in financing

Inability of non-state providers to maintain services

Disruption to supply chain (including pharmaceuticals)

Degraded alert and response

Migration of human resources for health

Damage to health facilities

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Attacks against health

4. Humanitarian health responsei. Health response organization

ii. Availability / functionality of humanitarian health resources

Facilities data (e.g., HeRAMS)4Wsiii. Humanitarian health system performanceUtilisation of services

Quality of humanitarian health services

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5. Information gaps

6. Addition

al Resources

Key documents

Health cluster contacts and report contributors

Gap Recommended tools / guidance for primary data collection

Health status and threats

Health System Needs

Health response organizationAvailability / functionality of humanitarian health resourcesHumanitarian health system performance