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Planning for Health Emergency Management

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Planning for Health Emergency Management First National Course on Public Health Emergency Management 12 23 March 2011. Muscat, Oman 1. Geographic description ... – PowerPoint PPT presentation

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Title: Planning for Health Emergency Management


1
Planning for Health Emergency Management
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

2
Learning Objectives
  • By the end of this module, the participant should
    be able to
  • Describe the steps of emergency response
  • planning process in terms of inputs,
  • outputs and outcomes
  • Create flowcharts for emergency response
  • planning
  • To identify the various plans that must be
  • developed and the harmonization
  • between them
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

3
The differences
  • Policy what must be done
  • Guidelines how to implement the policy
    technical how
  • Procedures how to implement the policy
  • administrative how
  • Protocols - step-by-step instructions to
    perform a given
  • activity
  • Plan who does what when to implement policy
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

4
The relationship
Mandates are needed to set policies Policies
are needed to define guidelines and set
procedures Guidelines and procedures are needed
to make plans Policy for health emergency
management is set at the national or sub-national
level, it is executed at the local level
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

5
Example
  • Policy - All victims of all sorts of emergencies
    or disasters shall be searched, rescued, and
    managed timely and appropriately
  • Guidelines Case Definition of victims
    Guidelines on
  • search, rescue, and case management
  • Procedures Procedures of patient referral
    emergency procurement of drugs and medicines
  • Plans - Emergency Manager responsible for
    triaging Details on who does what, responsible
    persons plan changes from one facility to
    another
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

6
THE CONTEXT OF COMMUNITY RISK MANAGEMENT
Public Safety

Risk Management
Emergency Management
Hazard Prevention
Damage Assessment Needs Analysis
Vulnerability Reduction
Epidemiology Reporting
Emergency Preparedness
Mass Casualty Management
Hospital Planning
Curative Care
Shelter Security
Water Sanitation
Control of Communicable Disease
Food Nutrition
Reproductive Health
Psychosocial Needs
Medical Supplies Logistics
Media Public Information
Recovery and Rehabilitation
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

6
safer communities
7
From Policy, Guidelines and Procedures to
Community Plans
National level
Policy, guidelines, procedures
Special plans
Mobilise extra-resources
Provincial level
International org assistance
Develop and implement
Vulnerability reduction plans
Community level
Emergency response plans
Preparedness programs
National provincial levels support
communities in their work
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

8
  • What are the Emergency Management
  • Plans?
  • Emergency Preparedness Program/Plan
  • Hazard Reduction Program
  • Vulnerability Reduction Program
  • Emergency Preparedness (Capacity Building
    Program)
  • Emergency Response Plan
  • Contingency Plan
  • Business Continuity Plan
  • Recovery/Rehabilitation Plan
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

9
  • Defining the various plans
  • National Plan
  • multi-sectoral plan
  • developed for the situations that are not
    under the
  • direct responsibility of regional and local
    authorities
  • coordination, resource mobilization,
    information
  • management
  • includes contingency plan
  • includes all the regional plans
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

10
  • Defining the various plans
  • Regional Plan
  • multi-sectoral plan
  • developed for the situations that are not
    under the
  • direct responsibility of local authorities
  • coordination, resource mobilization,
    information
  • management, service delivery
  • includes contingency plan
  • includes all the local plans
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

11
  • Defining the various plans
  • Local Plan
  • multi-sectoral and multi-disciplinary plan
  • developed for local situations
  • operationalize the national policy and
    guidelines
  • coordination, resource mobilization,
    information
  • management, service delivery, etc.
  • includes contingency plan
  • includes business continuity plan
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

12
National Plan
Regional Plan
Regional Plan
Regional Plan
Local Plan
Local Plan
Local Plan
Local Plan
Local Plan
Local Plan
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

13
Context of emergency plans for a community
Community Risk Management Plan
Sectoral Plans
Hazard Specific Plans
Provincial Emergency Disaster Plans
Agencies Specific Plans (hospitals)
National Emergency Disaster Plan
Intersectoral in nature
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

14
Disaster Management is
80 generic
15 specific
5 unique
to all disasters
to the hazard
to the event
1. Organization
earthquake
EOC
time
large numbers of trapped and injured
coordination
place
large numbers of homeless and displaced
communications
weather
large numbers of dead and missing
transport
logistics and supplies
geography
information and media
dead, injured and missing staff
climate
damaged critical infrastructure / resources
(hospitals, vehicles)
reporting and surveillance
loss of water, gas, electricity, phone,
transport, fuel networks
security
2. Response
loss of road, sea, air, rail infrastructure /
access
search and rescue
politics
long period of SAR, victim extraction
evacuation
economy
high demand for FA, stretchers, triage, medical
transport
mass casualty management
governance
high demand for beds, surgery, blood products,
referral
management of dead and missing
wound infections, amputations, tetanus, dust
inhalation
security
emergency management capacity
high demand for orthotics, prosthetics,
disability, dental
temporary shelter, clothing and utensils
logistics capacity
emergency water, sanitation and energy
demand for specialized spinal and head injury care
disposal of inappropriate donations
high demand for temporary shelter, food,
utensils, stoves,
emergency food supplies
water, energy, clothing, tents, blankets
emergency public and environmental health
leadership
high demand for psychosocial support of victims
and staff
emergency engineering and public works
solidarity
management of donated supplies / foreign teams
morale
3. Recovery
few outbreaks of communicable diseases
corruption
variable demand for medicines and equipment
crime
(acute / chronic injury care - high, infectious
disease - low,
curative and public health care
looting
potentially unstable chronic disease - medium)
education
agriculture
compensation claims
contamination of water, air and soil
trade and commerce
insurance claims
toxic chemical, sewerage and gas leaks / spills
4. Rehabilitation and Reconstruction
urban fires, explosions
ownership disputes
contaminated, infested and unsafe foods
people
property disputes
increased vector breeding
property
services
loss of livelihoods, markets, distribution
networks
livelihoods
environment
THIS IS WHAT WE PLAN FOR .
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

15
Planning for Emergencies
  • Planning based on risk analysis is planning for
    any emergency, by predicting
  • what might happen
  • when it might happen
  • where it might occur
  • how big it might be
  • what effect it might have
  • how long it might last (emergency recovery
    period)
  • What are the strategies to respond and recover
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

16
Main characteristics
  • Clear responsibilities (who, what, when, how,
    with
  • whom, where)
  • All key stakeholders need to be involved in
    the planning
  • process, including
  • agencies with disaster responsibilities
  • community members / groups
  • Institutions and legal authorities
  • Relevant to emergency events
  • large scale complex relatively rare hard to
    predict
  • Consequences of poor decisions can be acute
  • Scrutiny of mistakes is often in detail and in
    public
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

17
Essential Services
The following sectors are involved in the
emergency planning process
  • communications
  • police
  • relief and rescue
  • health
  • social welfare
  • transport
  • public works
  • also agriculture, media, education, fire,
    ambulance, engineering, meteorology
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

18
Health Sector Response Plan must deal with..
  • Casualty management (first aid, triage,
    transport, pre-hospital care, in-patient care,
    out-patient care)
  • Communicable disease control (surveillance,
    tracking, treatment, prophylaxis, isolation and
    quarantine)
  • Continuity of delivery of critical services for
    emergency patients
  • Management of the dead and missing
  • Management of information (public information
    support activities health info system)
  • Mental health
  • Environmental health
  • Reproductive health
  • Public health programs (continuity of essential
    programs)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

19
THE EMERGENCY PLANNING PROCESS
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

20
Elements of Hospital Preparedness, Response and
Recovery Plan
  • I. Background
  • II. Plan description
  • III. Goals and objectives
  • IV. Planning Group
  • V. Emergency Preparedness Plan
  • Hazards prevention
  • Vulnerabilities reduction
  • Risk reduction (capacity development)
  • VI. Management Structures
  • VII. Roles and responsibilities
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

21
Elements of Hospital Preparedness, Response and
Recovery Plan
  • VIII. Response Plan
  • Policies, guidelines, procedures, protocols for
    the developed systems
  • Response, Contingency, Business Continuity plan
  • Recovery and Reconstruction Plan
  • Damage Assessment and Needs Analysis
  • Post-incident evaluation
  • Recovery and rehabilitation Plan based on lessons
    learned
  • X. Annexes
  • Glossary
  • Abbreviations
  • Directory of contact persons
  • Inventory of resources of hospital and partner
    agencies
  • Hospital policies, guidelines, protocols, and
    other issuances relevant to emergency or disaster
    management
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

22
Emergency Planning Process
Analyze resources
Define the plan
Describe Roles and Responsibilities
Form Planning Group
Hazard Analysis
Describe Management Structure
Vulnerability Analysis
Risk Analysis
Develop Strategies and Systems
Problems/Gaps Analysis
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

Hospital Emergency Preparedness, Response and
Recovery Plan Development 08
23
The Planning Process
  • Determine the authority responsible for the
    process
  • Establish a planning committee and objectives
    management structure of the process
  • Assign responsibilities
  • Conduct a risk assessment - hazards and
    community vulnerabilities (core elements)
  • Identify and analyse capacities and resources
  • Stakeholders analysis
  • Develop strategies, emergency management systems
    and arrangements
  • Document the plan
  • Test the plan
  • Disseminate the plan
  • Review and update the plan on a regular basis
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

24
Background
  1. Name of the agency and address
  2. Geographic description (location Low lying area?
    Etc.)
  3. Demographic profile of catchments communities
  4. Community Profile
  5. Health statistics (IMR, MMR, etc.)
  6. Health facilities found in the municipality/city
  7. Available health services
  8. Manpower complementation
  9. Disasters responded/managed
  10. Legal issuances establishing authority in HEM
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

25
Significance
  1. Picture of the site and location of the hospital
  2. Catchments areas provided with hospital services
  3. Health resources in and around the hospital
  4. Existing capacity and capability of the hospital
  5. Partner agencies around the hospital
  6. Anticipated hazards as basis for hospitals
    capacity and capability building
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

26
Define Plan
  • Determine the aim, objectives and scope of the
  • planning process
  • Identify the tasks to be performed, and the
  • resources needed
  • Identification of the framework in which
  • emergencies will be managed
  • legislation policy and guidelines must be
  • considered
  • and the resources that will be required
  • stakeholders / agencies, etc.
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

27
Plan Definition
  • Brief description of the content of the plan
  • Specific intentions relevant to set goals and
    objectives.
  • Include the coverage, scope and limitations.
  • Include the legal basis whereby the hospital is
    authorized to
  • act in disaster situations
  • Legal issuances detailing the roles and
    functions of
  • hospitals in managing all phases of
    emergencies or
  • disasters
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

28
Scope of the Plan
  • Significance
  • Who will implement the plan
  • Extent of implementation including limitations

Goals and Objectives
  • Give the purpose of the plan from a broader to
    more
  • specific perspectives.
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

29
Review Planning Group/Committee
  • Key Stake-holders to be represented
  • multi-disciplinary teams are essential to
    ensure
  • sufficient expertise
  • must have appropriate authority
  • political and economic circumstances may
  • influence choice of members
  • social and cultural issues must be considered
  • there must be an efficient reporting system
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

30
Planning Group/Committee
  • Planning Committee include major stakeholders
  • Permanent or AD HOC Group which convenes only
    for emergency planning purposes.
  • This group shall be created through an order.
  • Roles and functions of the planning
    group/committee
  • Develops, reviews and updates the HEPRRP
  • Gathers required information and gain commitment
    of key people and organizations
  • Initiates testing of the plan for its
    functionality and adaptability to current
    situation
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

31
Example of Planning Committee Structure
Director/Designate
Representative from areas of operation
Representative from Administrative Division
Representative from Planning Division
Representative from the Finance Division
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

32
Risk Analysis
  • planning group should know result of
    vulnerability analysis (at least core elements)
  • technique for identifying preventive and
    mitigation strategies response and recovery
    strategies for identified problems
  • systematic breakdown of the problem into its
    components
  • techniques involves
  • hazard analysis / vulnerability/risk assessment
    / developing response and recovery strategies /
    mitigation
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

33

Emergency Preparedness Program Reminder
  • An integrated set of long-term, multi-sectoral
    development activities
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

34
Emergency Preparedness Program
  • Goal to achieve an increasing level of
    readiness within communities to cope with any
    situation which demands an emergency response,
    using their own resources. This requires the
    development and maintenance of
  • Political authority, policy for EM
  • Plans and Procedures for EM and Recovery
    training and education
  • Institutional and human resources for EM
  • Public awareness education
  • System for the collection, analysis and
    distribution of information related to emergencies
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

35
ANATOMY OF COMMUNITY RISK MANAGEMENT
Community risk
readiness
community

hazard
?
vulnerability
multisectoral, all hazards
indicators
indicators
indicators
indicators
probability scale/magnitude/ strength/intensity
spread duration biological hazards season,
infectivity, latency, transmission
resistance, etc.
policy, plans, procedures knowledge, skills,
attitudes resources legislation national
sectoral policy administrative procedures response
recovery plans preparedness plans technical
guidelines management structure institutional
managements information systems warning
systems human resources material
resources financial resources simulations
training education public information community
participation research publications
People access to health care measles
vaccination under 5 nutrition under 5
mortality access to clean water access to
sanitation adequate housing employment/
income female literacy Property health
infrastructure vehicles medical
supplies Services curative care
services ambulance services public health
services health info system Environment water/so
il/air quality
risk of death injury (mental/ physical) disease
(mental/physical) loss of life displacement loss
of property loss of income secondary
hazards breakdown in security damage to
infrastructure breakdown in services Contamination

natural phenomena famine diseases of epidemic
potential events/crowds intoxification infestation
s transport accidents structural
failures industrial accidents chemical
accidents pollution refugees war terrorism
Prevention Mitigation Programme
Vulnerability Reduction Programme
Emergency Preparedness Programme

Community Risk Management
?
?
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

36
Emergency Preparedness Program
  • Plan to build response capacity
  • Policies, Protocols, Guidelines and Procedures
  • Plans
  • People (Human Resource development)
  • Promotion and Advocacy
  • Partnership Building
  • Physical (Facility Enhancement)
  • Program Development
  • Practices documentation
  • Peso (Finance) and Logistics
  • Package of Services
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

37
Resource Analysis
  • why?
  • to ensure that PRR strategies can be supported
  • to ensure that preparedness is coordinated
  • to ensure cooperation between agencies
  • to know who is responsible for supplying
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

38
Organizational Capacity
  • implemented selectively by those agencies which
    have been delegated that responsibility by the
    Government or by the community
  • it is vital that..agencies
  • professionally managed
  • adequately resourced
  • highly trained
  • demonstrated competence
  • emergency management family
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

39
Assessment of Response Capacity of the Health
Sector
  • mandate and authority to deliver relief (scope of
    responsibility)
  • management and command structure (coordination
    among stakeholders)
  • competencies of staff (knowledge and skills and
    ability)
  • the availability and accessibility of information
  • the existence and relevance of plans
  • the existence and relevance of procedures
  • the networking of the plans of the Health Sector
    with the plans of the other sectors
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

40
Step 5 Roles and Responsibilities
  • should be defined described to ensure that
    each organization knows precisely what is
    expected of it and that everyone is aware of the
    general roles of all relevant organizations
  • multi-sectoral approach for national disaster
    plan
  • key issues
  • Information management
  • resource management
  • evacuation
  • specific situation such as hazardous material
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

41
Emergency Response Plan
  • It is important to have Emergency Response Plan
  • to have an orchestrated, timely, and appropriate
  • response actions
  • to save lives and reduce sufferings of the
    affected
  • population
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

42
Emergency Response Plan
  • A plan containing description of
  • Responsibilities
  • Command coordination mechanism
  • Management structures
  • Resource management
  • Information management and communication
  • Training and exercises
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

43
Difference between Emergency Response Planning
and Routine Planning
  • ERP focuses on
  • Coordination and management systems of resources
    from several sectors
  • emergency management and incident management
    systems
  • Management of information
  • arrangements for intra-sectoral and
    inter-sectoral coordination of activities and
    mobilization of resources (surge capacity)
  • What are the characteristics of routine planning
    in your field of activity?
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

44
Key characteristics of an ERP
  • Emergency Response Plan and Recovery Plan
  • an agreed set of arrangements for
  • responding to, and
  • recovering from emergencies
  • plans involve the description of
  • responsibilities
  • management structures
  • resource and information management
  • Logistics management
  • Training and exercises
  • plans focus on protecting life, property and
    environment
  • outcomes
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

45
Core Elements of an Emergency Response Plan
Management Structures
Incident Commander
Public Info. Officer
Safety Officer
Liaison Officer
Administrative/ Finance
Logistics
Planning
Operations
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

Hospital Emergency Preparedness, Response and
Recovery Plan Development 08
46
Emergency Response Plan Development
  • A response plan will define and discuss
  • a line of authority and clear responsibilities
    of all
  • the stakeholders involved
  • the management systems ICP EOC EEC
  • the communications system
  • alert and warning mechanisms
  • public information arrangements
  • resource management (human, financial and
    material)
  • Monitoring, reporting and accounting
    arrangements
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

47
Core Elements of an Emergency Response Plan
  • Emergency Response Policies, Guidelines,
    Procedures and Protocols
  • Activation of Code Alert System
  • Activation of the Plan
  • Incident Command System
  • Activation of the EOC
  • Information Management System
  • MHPSS
  • Security system
  • Public Information System
  • Coordination, networking and referral system
  • Provision of public health services
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

48
Core Elements of an Emergency Response Plan
  • Emergency Management Policies, Guidelines,
    Procedures and Protocols
  • k. Infection Control
  • l. System to upscale services in case of surge
    of patients
  • m. System on drills/simulation exercises
  • n. Stockpiling of emergency medicines and
    supplies
  • o. Logistics management system
  • p. Decontamination procedures
  • q. Management of the dead and missing persons
    during
  • disasters
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

49
Core Elements of an Emergency Response Plan
  • Emergency Management Policies, Guidelines,
    Procedures and Protocols
  • p. restoration of critical services
  • Electrical supply and back-up generators
  • Drinking water supply and alternate sources
  • Fuel reserves
  • Back-up communication system
  • Wastewater and solid waste water treatment
  • Fire suppression
  • q. SOP on managing volunteers and donations
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

50
Recovery and Reconstruction Plan
  • Damage Assessment and Needs Analysis
  • Post-incident Management
  • Medium-term and long term recovery,
    reconstruction,
  • and development plan
  • Multi-sectoral initiative (education,
    agriculture, public
  • works etc.)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

51
Next Actions
  • 1. Write the Plan and have it approved by the
    head of the agency. The Plan is not a plan until
    written and approved by the head of agency
  • 2. Disseminate the plan to all the stakeholders
    and staff. Everyone needs to know the plan so
    that in emergency no one would ever say, he does
    nothing cause he knows nothing.
  • Test the plan. The plan is believed to be
    effective only when it is tested, be able to know
    its functionality, acceptability, and doability
    in the hands of the implementers.
  • Update the plan
  • Implement the plan.
  • 5. Monitor and evaluate the implementation of
    the plan
  • 6. Review and update the plan regularly.
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

52
After the Plan has been developed
  • It is essential to
  • simulate an emergency to test the plan
  • familiarise all staff with the plan
  • brief all new staff about the plan
  • familiarise local government, emergency services
    and the community with the plan
  • train those staff with special roles and
    responsibilities in the plan
  • review and update the plan after an emergency,
    after each simulation and whenever new resources
    are acquired
  • conduct regular exercises
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

53
Evaluate the Plan
  • How do we know a plan is a functional plan?
  • it meets the national planning criteria and
    policy ?
  • it conforms to the national planning format ?
  • it has been developed through a true emergency
    planning process (from vulnerability analysis up
    to participation of end-users) ?
  • it is tested, validated and regularly exercised
    ?
  • all key staff are familiar with the details of
    the plan and know their responsibilities ?
  • WHAT DO YOU WANT TO ADD?
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

54
Other areas of enquiry
  1. Timeliness (as well as appropriateness)
  2. Connectedness (and coordination)
  3. Coherence (fits into the medium and long term
    plans of the government)
  4. Preparedness ( preparedness activities and the
    effectiveness of the activities undertaken)
  5. Evaluating the effectiveness of emergency
    preparedness programmes in normal times
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

55
Outputs of the intersectoral emergency planning
process
  • A set of emergency response plans who does what
    when using existing capacity
  • search and rescue plan
  • evacuation / temporary shelter plan
  • mass casualty plan / hospital plans
  • sectoral relief plans (food, water, health,
    lifelines etc.)
  • security plans
  • Mitigation EWS (MCM all hazards)
  • A disaster recovery and reconstruction plan
    (education, agriculture, public works etc.)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

56
MONITORING
INPUT
PROCESS
OUTPUT
OUT-COME
Resource Requirement
Strategies/ Activities
Performance Indicators
Impact Indicators
EVALUATION (Intervention)
Effectiveness Efficiency
Relevance Impact
Connectedness Coherence Preparedness
Coverage Timeliness
57
Evaluation Process
INPUT
PROCESS
OUTPUT
OUT-COME
Resource Requirement
Strategies/ Activities
Performance Indicators
Impact Indicators
EVALUATION (Intervention)
Effectiveness Efficiency
Relevance Impact
Connectedness Coherence Preparedness
Coverage Timeliness
58
  • Effectiveness
  • achieving objectives
  • doing the right thing right
  • includes cost- effectiveness
  • Efficiency
  • doing it right with as few resources as
  • possible (effort, time, money, people,
    material)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

59
  • Relevance/Appropriateness
  • doing the right thing in the right way at
  • the right time
  • Impact
  • doing the right thing
  • changing the situation more profoundly
  • and in longer term
  • Coverage
  • the extent to which interventions reach
  • the intended target population
  • linked to effectiveness
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

60
Outcomes of the emergency planning process
  • The planning process is a sequence of steps
    whereby a planning entity (e.g. government,
    community) agrees on ways to enhance and protect
    its own safety. It is an interactive and
    iterative process that should lead to
  • better understanding of the roles and
    responsibilities of all members of the community
    in prevention, mitigation, and response
  • greater awareness of risk reduction in the
    community
  • higher levels of readiness to respond and to
    recover
  • an emergency response plan and a recovery plan
    (and contingency plans when relevant)
  • increased public safety (including for the
    health sector such as safer hospitals, etc.)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

61
Common Planning Mistakes
  • the plan (paper document) is given more
    importance than the planning process itself
  • not key community members (or staff of the
    institutional plan) are aware of the existence of
    a plan
  • revision is overlooked
  • emergency planning is not integrated into normal
    activities (integration strategy) whenever
    possible
  • different plans are developed for different
    hazards by different agencies the all hazards
    approach should be preferred (no synergy no
    compatibility)
  • no or weak training programs
  • what do you want to add?
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

62
Common Planning Mistakes
  • Plans are out of date as soon as they are
    published
  • PLANS NEED REGULAR REVIEW
  • Procedures, policies and guidelines are needed to
    guide the planning process at local level
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

63
Emergency Risk Management Principles for
Agencies
goal to increase efficiency, effectiveness,
readiness and integration of the agency into the
overall organization of the emergency management
process and system
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

64
Principles for Agencies and emergency planning
needs
  • Objectives
  • to improve the decision making process at all
    levels (within agency)
  • to facilitate the choice of the most suitable
    strategies
  • to rely on specific decision making procedures
  • to ensure efficient communication
  • internal and external
  • to ensure safety and well being of staff
    /community
  • to promote and preserve the activities
    efficiency synergy, complementarities,
    adaptability, cooperation
  • to promote adequate training personnel /
    exercises.
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

65
Risk management and Planning - Principles for
Agencies
Define the ERM policy of the Agency
Enter the planning process (ERM)
Allocation of required resources of all kind
ERM process for an Agency
Implementation activities role - functions
Monitoring reevaluation process
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

66
Group Work Activity
  • Develop a Health Emergency Preparedness Program,
    Response Plan, and Recovery Plan for your
    respective area of responsibility
  • Local Plan
  • Regional Plan
  • National Plan
  • For academic purposes, choose a hazard to work on
    (All- hazard Approach)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

67
Updating the information on hazard and
vulnerabilities...
  • Why Emergency Response Plans must be regularly
    revised ?
  • update the current political, social and economic
    situation
  • update hazard reduction, emergency preparedness
    and vulnerability reduction activities in all
    sectors and by all organisations
  • update changes in resources, systems and
    procedures
  • update early warning information system
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

68
Early warning information...links with Response
Plans
  • The emergency response plans are useful only
  • when they are activated
  • they are relevant and functional
  • They are efficiently used
  • So the early activation of the response plans is
    essential. In many emergencies there is a time
    frame which allows for early activation (floods
    displacement of populations anticipated cold
    wave, start of an outbreak, etc.) and for
    developing further mitigation measures (early
    warning is critical)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

69
The Roles of National Government (1)
  • The role of national authorities is to support
    local planning processes by establishing the
    planning framework
  • setting national policies for risk reduction,
    emergency
  • preparedness, emergency response and disaster
    recovery
  • issuing technical guidelines and administrative
    procedures
  • for the process of planning and for the
    implementation of
  • the policy (contents of the plans, etc.)
  • developing national plans (multi-sectoral
    sectoral
  • contingency) for those situations that are
    not under the
  • direct responsibility of local authorities
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

70
The Roles of National Government (2)
  • developing procedures for how national resources
    can be deployed in an emergency
  • allocating funds to support the development of
    new local capacity and for local risk reduction
  • planning for those hazards that are not the
    primary responsibility of local government e.g.
    Security
  • international cooperation and assistance
  • WHAT ARE THE PRESENT CONSTRAINTS IN YOUR COUNTRY
    ?
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

71
Main responsibilities of MOH in emergency planning
  • Reduce the vulnerabilities of its own
    infrastructures andsystems hospital mitigation
    EMS System etc.
  • Raise awareness first of the health staff then
    of the general public (in collaboration with
    other sectors)
  • Reduce health consequences of crisis and major
    emergencies (core function of the health sector).
    A health emergency management program/unit
    should be institutionalised within the MOH
    development of emergency response plans
  • Assume its normative role and lead function
    (guidance) in health (emergency preparedness and
    risk management)
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

72
Overall strategy of the MOH
  • Integration strategy
  • Vulnerability reduction and hazard mitigation
  • Community risk management framework
  • Inter-sectoral cooperation
  • Planning based on existing resources (all
    types)
  • Decentralization of the response capacity
  • Community participation (and end-users)
  • Institutionalization of an emergency/disaster
    Unit within
  • the MOH
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman

73
THANK YOU
  • First National Course on Public Health Emergency
    Management
  • 12 23 March 2011. Muscat, Oman
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