Your search found 41 Results

  1. 1
    374451

    10 essential facts about reproductive health in humanitarian emergencies.

    Population Action International [PAI]

    Washington, D.C., PAI, 2015 Aug. 2 p.

    There are more people displaced in the world today than at any other point in history, and more than 75 percent of those needing humanitarian assistance are women and children. In humanitarian emergencies, many women want to avoid pregnancy; however they lack access to the services and supplies that would allow them to delay pregnancy. To meet the reproductive health needs of people in humanitarian emergencies, organizations and policymakers should know the answers to these 10 critical questions.
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  2. 2
    374442

    Pakistan: increasing access to SRH services in fragile contexts for rural women in hard-to-reach areas.

    International Planned Parenthood Federation [IPPF]. South Asia Regional Office

    London, United Kingdom, IPPF, 2015 Sep. 2 p.

    In some areas of Pakistan, girls and women are vulnerable to harmful traditional practices, like swara (now illegal, a form of reconciliation where a girl or woman is given in marriage to settle a dispute) and early marriage, and many of them face tremendous obstacles to basic services, including sexual and reproductive health (SRH) services.
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  3. 3
    375642

    Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Second edition.

    World Health Organization [WHO]; United Nations Population Fund [UNFPA]; UNICEF

    Geneva, Switzerland, WHO, 2017. 492 p. (Integrated Management Of Pregnancy And Childbirth)

    Since the first edition was published in 2000, the Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new World Health Organization recommendations, resulting in this second edition.
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  4. 4
    340332

    Emergency Plan of Action (EPoA), Honduras: Health emergency -- Zika.

    International Federation of Red Cross and Red Crescent Societies

    [Geneva, Switzerland], International Federation of Red Cross and Red Crescent Societies, 2016 Feb 29. [14] p.

    This document is an emergency plan of action created by International Federation of Red Cross and Red Crescent Societies for the country of Honduras. The document includes a situational analysis of the Zika emergency in Honduras and an operational strategy and plan to combat the outbreak.
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  5. 5
    370247
    Peer Reviewed

    Severe maternal morbidity and near misses in tertiary hospitals, Kelantan, Malaysia: a cross-sectional study.

    Norhayati MN; Hazlina NHN; Sulaiman Z; Azman MY

    BMC Public Health. 2016 Mar 5; 16(229):1-13.

    Background Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia. Methods A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organization criteria. Health indicators for obstetric care were calculated and descriptive analyses were performed using SPSS version 22.0. Results In total, 21,579 live births, 395 women with severe maternal morbidity, 47 women with maternal near miss and two maternal deaths were analyzed. The severe maternal morbidity incidence ratio was 18.3 per 1000 live births and the maternal near miss incidence ratio was 2.2 per 1000 live births. The maternal near miss mortality ratio was 23.5 and the mortality index was 4.1%. The process indicators for essential interventions were almost 100.0%. Haemorrhagic disorders were the most common event for severe maternal morbidity (68.6%) and maternal near miss (80.9%) and management-based criteria accounted for 85.1%. Conclusions Comprehensive emergency care and intensive care as well as overall improvements in the quality of maternal health care need to be achieved to substantial reduce maternal death.
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  6. 6
    333218

    Making reproductive rights and sexual and reproductive health a reality for all. Reproductive rights and sexual and reproductive health framework.

    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, 2008 May. [40] p.

    The Reproductive rights and sexual and reproductive health (SRH) framework has been developed to provide overall guidance and a cohesive- Fund-wide response for implementing the Reproductive Health and Rights elements of the UNFPA Strategic plan 2008-2011. The framework builds on the goals of the International Conference on Population and Development (ICPD), 1994; the Millennium Summit, 2000, with its adoption of the Millennium Development Goals (MDGs); the 2005 World Summit; and the addition, in 2007, of the goal of universal access to reproductive health to MDG 5, for improving maternal health. This includes two parts: the first provides a snapshot of the progress achieved since ICPD, identifies major remaining gaps and priorities and outlines principles and approaches for programme planning and implementation. The second part identifies key priorities and specific strategies for each of the SRH-related strategic plan outcomes. (Excerpt)
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  7. 7
    333217

    Inter-agency field manual on reproductive health in humanitarian settings. 2010 revision for field review.

    Inter-agency Working Group on Reproductive Health in Crises

    [New York, New York]. Inter-agency Working Group on Reproductive Health in Crises, 2010. [222] p.

    The 2010 Inter-agency Field Manual on Reproductive Health in Humanitarian Settings is an update of the 1999 Reproductive Health in Refugee Situations: An Inter-agency Field Manual, the authoritative guidance on reproductive health interventions in humanitarian settings. The 2010 version provides additional guidance on how to implement the Minimum Initial Service Package (MISP) for Reproductive Health, a minimum standard of care in humanitarian response. It also splits the original chapter on HIV and Sexually Transmitted Infections (STIs) into two separate chapters to accommodate new guidance on HIV programming. A new chapter on Comprehensive Abortion Care has been developed to cover more than post-abortion care. The chapters on Program Design, Monitoring and Evaluation and Adolescent Reproductive Health have been placed earlier in the manual to address the cross-cutting nature of these topics. Information on human rights and legal considerations has been integrated into each of the thematic chapters to ensure that program staff can address rights-related concerns. The updated information is based on normative technical guidance of the World Health Organization. It also reflects the good practices documented in crisis settings around the world since the initial field-test version was released in 1996. The latest edition reflects the wide application of the Field Manual's principles and technical content beyond refugee situations, extending its use into diverse crises, including conflict zones and natural disasters.
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  8. 8
    333197

    mHealth: New horizons for health through mobile technologies. Based on the findings of the Second Global Survey on eHealth.

    World Health Organization [WHO]. Global Observatory for eHealth

    Geneva, Switzerland, WHO, 2011. [112] p. (Global Observatory for eHealth Series Vol. 3)

    This report aims to make policy-makers aware of the mHealth landscape and the main barriers to implement or scale mHealth projects. It combines the results and analysis of the data gathered from the mHealth survey and is complemented by five country case studies and a review of the current literature related to mHealth. (Excerpt)
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  9. 9
    328890
    Peer Reviewed

    Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5.

    Koblinsky M; Anwar I; Mridha MK; Chowdhury ME; Botlero R

    Journal of Health, Population, and Nutrition. 2008 Sep; 26(3):280-94.

    Bangladesh is on its way to achieving the MDG 5 target of reducing the maternal mortality ratio by three-quarters between 1990 and 2015, but the annual rate of decline needs to triple. Although the use of skilled birth attendants has improved over the past 15 years, it remains less than 20% as of 2007 and is especially low among poor, uneducated rural women. Increasing the numbers of skilled birth attendants, deploying them in teams in facilities, and improving access to them through messages on antenatal care to women, have the potential to increase such use. The use of caesarean sections is increasing although not among poor, uneducated rural women. Strengthening appropriate quality emergency obstetric care in rural areas remains the major challenge. Strengthening other supportive services, including family planning and delayed first birth, menstrual regulation, and education of women, are also important for achieving MDG 5.
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  10. 10
    326599
    Peer Reviewed

    Emergency obstetric care in Punjab, Pakistan: Improvement needed.

    Ali M; Ahmed KM; Kuroiwa C

    European Journal of Contraception and Reproductive Health Care. 2008 Jun; 13(2):201-207.

    This paper describes an approach to maternal mortality reduction in Pakistan that uses UN emergency obstetric care (EmOC) process indicators to examine if public health care centres in Pakistan's Punjab province comply with minimum recommendations for basic and comprehensive services. In a cross sectional study in September 2003, through random sampling at area and health-facility levels from 30% of districts in Punjab province (n = 11/34 districts), all public health facilities providing EmOC were included (n = 120). Facility data were used for analysis. No district in Punjab met the minimum standards laid down by the UN for providing EmOC services. The number of facilities providing basic and comprehensive EmOC services fell far short of recommended levels. Only 4.7% of women with complications attended hospitals. Caesarean section was carried out in only 0.4% of births. The case fatality rate was hard to accurately calculate due to poor record keeping and data quality. The study may be taken asa baseline for developing and improving the standards of services in Punjab province. It is vital to upgrade existing basic EmOC facilities and to ensure that staff skills be improved, facilities be better equipped in critical areas, and record keeping be improved. Hence to reduce maternal mortality, facilities for EmOC must exist, be accessible, offer quality services, and be utilized by patients with complications. (author's)
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  11. 11
    323434
    Peer Reviewed

    Reducing the impact of climate change.

    Brown H

    Bulletin of the World Health Organization. 2007 Nov; 85(11):824-825.

    The most recent report of the Intergovernmental Panel on Climate Change (IPCC) found that there is overwhelming evidence that humans are affecting climate and it highlighted the implications for human health. The World Health Organization (WHO) is helping countries respond to this challenge, primarily by encouraging them to build and reinforce public health systems as the first line of defence against climate-related health risks. (excerpt)
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  12. 12
    323433

    Inter-agency agreement on mental health and psychosocial support in emergency settings [editorial]

    Inter-Agency Standing Committee Task Force on Mental Health and Psychosocial Support in Emergency Settings

    Bulletin of the World Health Organization. 2007 Nov; 85(11):822.

    Armed conflicts and natural disasters cause substantial psychological and social suffering to affected populations. Despite a long history of disagreements, international agencies have now agreed on how to provide such support. The Inter-Agency Standing Committee (IASC), established in response to United Nations General Assembly Resolution 46/182, is a committee of executive heads of United Nations agencies, intergovernmental organizations, Red Cross and Red Crescent agencies and consortia of nongovernmental organizations responsible for global humanitarian policy. In 2005, the IASC established a task force to develop guidelines on mental health and psychosocial support in emergencies. The guidelines use the term "mental health and psychosocial support" to describe any type of local or outside support that aims to protect or promote psychosocial well being or to prevent or treat mental disorders. Although "mental health" and "psychosocial support" are closely related and overlap, in the humanitarian world they reflect different approaches. Aid agencies working outside of the health sector have tended to speak of supporting psychosocial well being. Health sector agencies have used the term mental health, yet historically also use "psychosocial rehabilitation" and "psychosocial treatment" to describe nonbiological interventions for people with mental disorders. Exact definitions of these terms vary between and within aid organizations, disciplines and countries, and these variations fuel confusion. The guidelines' reference to mental health and psychosocial support serves to unite a broad group of actors and communicates the need for complementary supports. (excerpt)
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  13. 13
    321141

    Adolescent pregnancy -- unmet needs and undone deeds. A review of the literature and programmes.

    Neelofur-Khan D

    Geneva, Switzerland, World Health Organization [WHO], 2007. [109] p. (WHO Discussion Papers on Adolescence; Issues in Adolescent Health and Development)

    The World Health Organization (WHO) has been contributing to meeting the Millennium Development Goals (MDGs) by according priority attention to issues pertaining to the management of adolescent pregnancy. Three of the aims of the MDGs - empowerment of women, promotion of maternal health, and reduction of child mortality - embody WHO's key priorities and its policy framework for poverty reduction. The UN Special Session on Children has focused on some of the key issues affecting adolescents' rights, including early marriage, access to sexual and reproductive health services, and care for pregnant adolescents. This review of the literature was conducted to identify (1) the major factors affecting the pregnancy outcome among adolescents, related to their physical immaturity and inappropriate or inadequate healthcare-seeking behaviour, and (2) the socioeconomic and political barriers that influence their access to health-care services and information. The review also presents programmatic evidence of feasible measures that can be taken at the household, community and national levels to improve pregnancy outcomes among adolescents. (excerpt)
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  14. 14
    314626

    Women are the fabric: reproductive health for communities in crisis.

    Del Vecchio D

    New York, New York, United Nations Population Fund [UNFPA], 2006. [16] p.

    Even in times of peace, it is usually women who look after children, the sick, the injured and the elderly. When emergencies strike, this burden of care can multiply. In many cases, women become the sole providers and caretakers for their households, and sometimes the families of others -- especially when men have been killed, injured or must leave their communities to fight or rebuild. During crisis and in refugee situations, women and girls become the ultimate humanitarian workers. They obtain food and fuel for their families, even when it is unsafe to do so. They are responsible for water collection, even when water systems have been destroyed and alternate sources are far away. They help to organize or rebuild schools. They protect the vulnerable and care for sick and disabled family members and neighbours. Women are also likely to take on additional tasks, including construction and other physical labour, and activities to generate income for their families. In many conflict zones, women's actions also help to bring about and maintain peace. Women care for orphaned children who might otherwise become combatants. They organize grass-roots campaigns, sometimes across borders, to call for an end to fighting. When the situation stabilizes, women work together to mend their torn communities. They help rebuild, restore traditions and customs, and repair relationships -- all while providing care for the next generation. (excerpt)
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  15. 15
    312682
    Peer Reviewed

    Using UN process indicators assess needs in emergency obstetric services:Gabon, Guinea-Bissau, and The Gambia.

    Fauveau V

    International Journal of Gynecology and Obstetrics. 2007 Mar; 96(3):233-240.

    We report on assessments of the needs for emergency obstetric care in 3 West African countries. All (or almost all) medical facilities were visited to determine whether there are sufficient facilities of adequate quality to manage the expected number of obstetric emergencies. Medical facilities able to provide emergency obstetric care were poorly distributed and often were unable to provide needed procedures. Too few obstetricians and other providers, lack of on-the-job training and supervision were among the challenges faced in these countries. (author's)
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  16. 16
    309272
    Peer Reviewed

    The United Nations Process Indicators for emergency obstetric care: Reflections based on a decade of experience.

    Paxton A; Bailey P; Lobis S

    International Journal of Gynecology and Obstetrics. 2006 Nov; 95(2):192-208.

    The paper reviews the experience with the EmOC process indicators, and evaluates whether the indicators serve the purposes for which they were originally created -- to gather and interpret relatively accessible data to design and implement EmOC service programs. We review experience with each of the 6 process indicators individually, and monitoring change over time, at the level of the facility and at the level of a region or country. We identify problems encountered in the field with data collection and interpretation. While they have strengths and weaknesses, the process indicators in general serve the purposes for which they were developed. The data are easily collected, but some data problems were identified. We recommend several relatively minor modifications to improve data collection, interpretation and utility. The EmOC process indicators have been used successfully in a wide variety of settings. They describe vital elements of the health system and how well that system is functioning for women at risk of dying from major obstetric complications. (author's)
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  17. 17
    307488
    Peer Reviewed

    Maternal mortality reduction by improving emergency obstetric care (EmOC) service.

    Dubey RD

    Journal of the Indian Medical Association. 2005 Aug; 103(8):[3] p..

    According to WHO estimates 585,000 maternal deaths occur worldwide every year. Maternal death is defined by WHO as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration or site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental causes". The maternal mortality ratio (maternal death per 100,000 live births) in our country is 407, according to one estimate. The maternal mortality rate (maternal death per 100,000 women aged 15-49 per year) is 1201. Though, considering the abysmal situation of data collection in our country, these figures may not be accurate and differ widely in different estimates, the figures are quite high compared to developed countries. This disproportional burden of death and disease borne by women in developing countries is indicative of dysfunctional and inequitable health care systems. The five major causes responsible for 80 per cent of maternal deaths are haemorrhage, sepsis, pre-eclampsia and eclampsia, obstructed labour and unsafe abortion. Although reduction in maternal mortality does not depend on the development of new technologies, it does require access to a functional health care system. The five major causes of maternal death are neither predictable nor treatable without access to facility-based emergency obstetric care as a part of responsive, equitable health care system. (excerpt)
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  18. 18
    300895
    Peer Reviewed

    Can the process indicators for emergency obstetric care assess the progress of maternal mortality reduction programs? An examination of UNFPA Projects 2000-2004. [Les indicateurs de processus pour les soins obstétriques d’urgence peuvent-ils évaluer les progrès des programmes de réduction de la mortalité maternelle ? Un examen des projets du FNUAP 2000-2004]

    Fauveau V; Donnay F

    International Journal of Gynecology and Obstetrics. 2006 Jun; 93(3):308-316.

    In view of the disappointing progress made in the last 20 years in reducing maternal mortality in low-income countries and before going to scale in implementing the new evidence-based strategies, it is crucial to review and assess the progress made in pilot countries where maternal mortality reduction programs focused on emergency obstetric care. The objective was to review the process indicators recommended for monitoring emergency obstetric care and their application in field situations, examining the conditions under which they can be used to assess the progress of maternal mortality reduction programs. Five of the six UN recommended process indicators were monitored annually for 5 years in selected districts of Morocco, Mozambique, India and Nicaragua. Trends are presented and discussed. With specific variations due to different local situations in the four countries and in spite of variations in quality of data collection, all indicators showed a consistent positive trend, in response to the inputs of the programs. The UN process indicators for emergency obstetric care should continue to be promoted, but with two important conditions: (1) data collection is carefully checked for quality and coverage; (2) efforts are made to match process and outcome indicators (maternal and perinatal mortality, incidence of complications). (author's)
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  19. 19
    295033

    Coping with crises. How providers can meet reproductive health needs in crisis situations. Face aux crises. Comment les prestataires peuvent répondre aux besoins de santé dans des situations de crises.

    Ramchandran D; Gardner R

    Population Reports. Series J: Family Planning Programs. 2005 Dec; (53):1-19.

    Know what to do. The materials that guide international humanitarian relief providers-- particularly the Inter-Agency Field Manual and its Minimum Initial Service Package (MISP)-- can inform local providers of the reproductive health care needs of refugees. Kits of supplies that are part of the MISP can be ordered. Disaster preparedness training courses can help providers and government officials respond effectively when crises occur. Plan ahead. Make emergency preparedness plans that consider staffing, logistics, supplies, infrastructure, establishing relationships with news media, and coordination with other organizations. Plan for contingencies. Offer care immediately if a crisis occurs. Coordination is desirable but takes time, while health needs are urgent and great. (excerpt)
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  20. 20
    296296

    Annual report 2004.

    UNICEF

    New York, New York, UNICEF, 2005 Jul. 52 p.

    It was a natural disaster of unprecedented scale that elicited a never-before-seen outpouring of support and concern worldwide. An estimated 300,000 people across Asia and eastern Africa were left dead or missing and hundreds of thousands more displaced after the devastating earthquake and tsunami in the Indian Ocean on 26 December 2004. Children accounted for more than one third of the casualties. UNICEF's swift and effective tsunami response was rooted in its long presence in or near all of the affected countries. Within weeks, some 350 staff members had been deployed to provide relief, 300 from within the affected countries themselves. UNICEF's priorities were keeping children alive, caring for those separated from their families, protecting children from exploitation and abuse, and getting children quickly back to school. (excerpt)
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  21. 21
    296295

    Emergency field handbook: a guide for UNICEF staff.

    UNICEF

    New York, New York, UNICEF, 2005 Jul. [420] p.

    Since its inception, UNICEF has provided life-saving assistance and assured protection for children in emergencies - both natural and man-made. Guiding UNICEF's response in humanitarian situations is the principle that children in the midst of natural disasters and armed conflict have the same needs and rights as children in stable situations. Emergencies have grown increasingly complex and their impact is especially devastating on the most vulnerable. In health and nutrition, water and sanitation, protection, education and HIV/AIDS, UNICEF's Core Commitments for Children in Emergencies are not merely a mission statement - they are a humanitarian imperative. UNICEF will keep these commitments and ensure a reliable, timely response in emergencies. The Core Commitments also provide a framework within which we work with our key national, United Nations and non-governmental partners to provide humanitarian assistance. This handbook has been developed as a practical tool for UNICEF field staff to meet the needs of children and women affected by disasters. It is the result of extensive consultation. We urge you to use it as an essential reference tool and to share it with our key partners. (excerpt)
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  22. 22
    296555

    The strategy of humanitarian assistance.

    Kunugi T

    UN Chronicle. 1987 May; 24:[4] p..

    Recent studies on emergency and disaster relief have pointed to the need to further strengthen and improve the emergency-related capacities of the United Nations system and for arrangements for more effective use of those capacities. Nearly 40 per cent of the total United Nations resources during 1984 and 1985 were allocated to humanitarian activities, surpassing the percentage resources--some 34 per cent--for operational activities and other programmes in the economic and social sectors. Furthermore, in the past few years there has been a marked increase in resource allocation for humanitarian assistance around the world. In his book, The Quality of Mercy, William Shawcross says: "Humanitarian aid is often required because of abject political failure. It is neither intended, nor is it able, to resolve political crises that Governments have created or at least failed to address.' Referring to the Kampuchean operation, he states that one effect of such aid has been "to reinforce the political stalemate". Thus humanitarian aid does have political implications, with both pitfalls and constructive potential for facilitating a solution to an impasse. Because of ever-increasing humanitarian problems and such political implications, there is definite need for a new policy science of humanitarian assistance in the world today. (excerpt)
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  23. 23
    296547

    'The silent emergencies:' 1987 State of World's Children - UNICEF report.

    UN Chronicle. 1987 May; 24:[5] p..

    While the media focus on Africa from 1984 to 1986 brought extraordinary assistance to that crisis-ridden continent, it may have tended to obscure everyday emergencies wrought by disease and malnutrition elsewhere in the world. Recent events in Africa have alerted United Nations agencies once again that ways must be found to sensitize politicians as well as the press to what the United Nations Children's Fund (UNICEF) Executive Director James P. Grant has called the "silent emergencies'--the less dramatic continuum of death and human suffering imposed by poverty and ignorance. In the UNICEF State of the World's Children Report for 1987, Mr. Grant notes that over the past two years, more children died in India and Pakistan than in most nations of Africa combined. "In 1986, more children died in Bangladesh than in Ethiopia, more in Mexico than in the Sudan, more in Indonesia than in all eight drought stricken countries of the Sahel', he says. (excerpt)
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  24. 24
    294425
    Peer Reviewed

    International Organization for Migration: experience on the need for medical evacuation of refugees during the Kosovo crisis in 1999.

    Szilard I; Cserti A; Hoxha R; Gorbacheva O; O'Rourke T

    Croatian Medical Journal. 2002; 43(2):195-198.

    The International Organization for Migration (IOM) developed and implemented a three-month project entitled Priority Medical Screening of Kosovar Refugees in Macedonia, within the Humanitarian Evacuation Program (HEP) for Kosovar refugees from FR Yugoslavia, which was adopted in May 1999. The project was based on an agreement with the office of United Nations High Commission for Refugees (UNHCR) and comprised the entry of registration data of refugees with medical condition (Priority Medical Database), and classification (Priority Medical Screening) and medical evacuation of refugees (Priority Medical Evacuation) in Macedonia. To realize the Priority Medical Screening project plan, IOM developed and set up a Medical Database linked to IOM/UNHCR HEP database, recruited and trained a four-member data entry team, worked out and set up a referral system for medical cases from the refugee camps, and established and staffed medical contact office for refugees in Skopje and Tetovo. Furthermore, it organized and staffed a mobile medical screening team, developed and implemented the system and criteria for the classification of referred medical cases, continuously registered and classified the incoming medical reports, contacted regularly the national delegates and referred to them the medically prioritized cases asking for acceptance and evacuation, and co-operated and continuously exchanged the information with UNHCR Medical Co-ordination and HEP team. Within the timeframe of the project, 1,032 medical cases were successfully evacuated for medical treatment to 25 host countries throughout the world. IOM found that those refugees suffering from health problems, who at the time of the termination of the program were still in Macedonia and had not been assisted by the project, were not likely to have been priority one cases, whose health problems could be solved only in a third country. The majority of these vulnerable people needed social rather than medical care and assistance - a challenge that international aid agencies needed to address in Macedonia and will need to address elsewhere. (author's)
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  25. 25
    294423
    Peer Reviewed

    Primary health care in complex humanitarian emergencies: Rwanda and Kosovo experiences and their implications for public health training. [Soins de santé primaire dans le cadre d'urgences humanitaires complexes : les expériences du Rwanda et du Kosovo, et leurs implications dans le domaine de la formation en santé publique]

    Gardemann J

    Croatian Medical Journal. 2002; 43(2):148-155.

    In a complex humanitarian emergency, a catastrophic breakdown of political, economic, and social systems, often accompanied by violence, contributes to a long-lasting dependency of the affected communities on external service. Relief systems, such as the Emergency Response Units of the International Federation of Red Cross and Red Crescent Societies, have served as a sound foundation for fieldwork in humanitarian emergencies. The experience in emergencies gained in Rwanda in 1994 and Kosovo in 1999 clearly points to the need for individual adjustments of therapeutic standards to preexisting morbidity and health care levels within the affected population. In complex emergencies, public health activities have been shown to promote peace, prevent violence, and reconcile enemies. A truly democratic and multiprofessional approach in all public health training for domestic or foreign service serves as good pattern for fieldwork. Beyond the technical and scientific skills required in the profession, political, ethical, and communicative competencies are critical in humanitarian assistance. Because of the manifold imperatives of further public health education for emergency assistance, a humanitarian assistance competence training center should be established. Competence training centers focus on the core competencies required to meet future needs, are client-oriented, connect regional and international networks, rely on their own system of quality control, and maintain a cooperative management of knowledge. Public health focusing on complex humanitarian emergencies will have to act in prevention not only of diseases and impairments but also of political tension and hatred. (author's)
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