Enhancing community preparedness and response to emergencies within PHC

1. Enhancing community preparedness and response to emergencies within PHC Models of Interaction between Primary Health Care and Emergency Preparedness and response Presentation by Dr. Khatib Omar PM/EHA

2. Enhancing community preparedness and response to emergencies within PHC Magnitude of Emergencies in AFRO Context PHC Principles and Humanitarian Principles Role of Communities in PHC and EPR Interaction between PHC, EPR and Development Strategies of PHC and EPR Levels of implementation of the PHC approach and the EPR program. CONCLUSION

3. Emergency is real in AFRO countries More than 70% of countries reported emergencies in 1Q of 2008 16 reporting more than 1 emergency A total of 589 million people affected directly or indirectly Key Conflict/civil strife Complex emergency Natural Disaster Fragile situation Countries in Recovery Disease outbreaks No report in 2008 Non AFRO Countries Multiple emergencies/outbreaks Introduction: Magnitude of Emergencies in AFRO

4. Introduction: Context • Emergency disrupts the PHC – health workers and health facilities • Health Service provisions are disrupted and NGOs taking over and debates about shelving the "pay for service" policy in favor of free health care!!! • Disrupted communities (due to emergency/conflicts) and the loss of income negatively affects health care financing • Emergency/conflict situation has a marked influence on Government stewardship of health services especially when Government contribution in PHC is less than that of NGOs

5. Introduction: Context • Emergencies and disasters especially in the African region strike communities without warning. • The preparedness is poor and resilience is usually nil. • Large portions of the population are displaced in a chaotic and disorganized manner. • The displaced end up as recipients of “Humanitarian Aid” in a passive manner, without their involvement. • They usually have no power to determine what, when and where the humanitarian support should go to. • Many of these anomalies could be addressed using the PHC approach.

6. Introduction: PHC Principles and Humanitarian Principles • PHC core values and emergency preparedness and response principles have several common issues. • Primary Health Care revolves around a set of guiding principles, namely: • Social justice • Equity • Human Rights • Maximum community and individual self-reliance and participation • Emergency response revolves around humanitarian principles • Humanity • Neutrality • Impartiality • Independence

7. Role of Communities in PHC and EPR • A common objective for both PHC and EPR is to protect lives, health, environment and society • Community empowerment in PHC is done through the participation of local communities • Communities when mobilized ensure: • Individuals and households promote and protect their health and interests. • Oversight over services that they use. • Ownership of services to ensure that the best possible care is provided. • Inter-sectoral action is achieved • Progressive monitoring and surveillance of events such as deaths or illnesses in their communities.

8. Role of Communities in PHC and EPR • Increasing resilience of communities to disasters implies minimizing the risks to health by emergencies for these communities. • A well prepared community, even when facing an emergency, will be able to mitigate its effects, and spring back into sustainable development. • A well developed community will have a strong EPR program

9. Interaction between PHC, EPR and Development

10. PHC EPR Integration of health sector programs and plans Relevant to community needs All-hazard, Whole-health, Inter-disciplinary Accessibility to services by all Partnership & coordination between communities & levels Community empowerment Building resilience, reducing vulnerability, reducing risk and strengthening emergency management Community-based, participatory Reorienting human & financial resources Strategies of PHC and EPR

11. PHC EPR Policies, strategies, legislations, national plans, norms, standards, guidelines Inter-sectoral coordination National Policies, strategies, legislations, national plans, norms, standards, guidelines, Inter-sectoral coordination Provincial plans, training of human resources, data analysis and interpretation for disease surveillance, coordination with other provinces, supervision on the district level. Provincial/Teaching/ Third level health facilities Inter-sectoral coordination Provincial Provincial plans, training of human resources inc. training of trainers, data analysis and interpretation for risk monitoring, early warning and risk reduction, improving preparedness, coordination with other provinces, Inter-sectoral coordination General hospitals (secondary level) and health centres (primary level), basic health services, training, data collection and analysis, raising community awareness Inter-sectoral coordination District Health facility plans, human resource development, raising community awareness, data collection, analysis and mapping Inter-sectoral and inter disciplinary coordination Community health workers, health promotion and health education, community volunteers Community Community volunteers, early warning, community awareness and previous experience, first aid and basic SAR, social mobilization Levels of implementation of the PHC approach and the EPR program.

12. CONCLUSION • A well prepared country or community will have a strong EPR program and when facing an emergency, will be able to mitigate its effects, and spring back into sustainable development • a well designed and country specific health system will accommodate the PHC approach as its nucleus providing a PHC health sector environment to adopt an elaborate EPR program

13. Thank you