Lessons Learned from Reproductive Health Surveillance in Za atari Refugee Camp Jordan,

Transcription

1 Lessons Learned from Reproductive Health Surveillance in Za atari Refugee Camp Jordan, Michelle Dynes, EIS Officer/Epidemiologist, CDC Rachel Idowu, Medical Epidemiologist, CDC Ann Burton, Senior Public Health Officer, UNHCR Dina Jardaneh, Associate Public Health Officer, UNHCR Maysa Al-Khateeb, Emergency Reproductive Health Officer, UNFPA Shible Sahbani, Humanitarian Coordinator, UNFPA Sathyanarayanan Doraiswamy, Emergency RH Officer, UNHCR Basia Tomczyk, Health Scientist, CDC Center for Global Health Emergency Response and Recovery Branch

2 Za atari Refugee Camp Reproductive Health Surveillance BACKGROUND

3 Syrian Refugees Today

4 Syrian Refugees Today 155,

5 Syrian Refugees Today 155,647 18,

6 Jordan and Za atari Refugee Camp Aug 2013

7 Jordan and Za atari Refugee Camp Aug 2013 More than 520,000 refugees in Jordan Majority of refugees in urban settings

8 Jordan and Za atari Refugee Camp Aug 2013 More than 520,000 refugees in Jordan Majority of refugees in urban settings Over 120,000 Syrian refugees in Za atari camp 30,504 women aged ,660 pregnant women

9 Photo 7/2013:

10 Za atari Refugee Camp Reproductive Health Surveillance HEALTH INFORMATION SYSTEM

11 UNHCR Health Information System (HIS)

12 UNHCR Health Information System (HIS) Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp settings

13 UNHCR Health Information System (HIS) Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp settings Up to 10 technical sections with three core pillars

14 UNHCR Health Information System (HIS) Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp settings Up to 10 technical sections with three core pillars Standards and Indicators Tools and Guidelines Coordination and Support

15 UNHCR Health Information System (HIS) Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp settings Up to 10 technical sections with three core pillars Standards and Indicators Tools and Guidelines Coordination and Support

16 UNHCR Health Information System (HIS) Standardized tool to design, monitor, and evaluate refugee public health HIS is implemented in over 18 countries Targets over 2.1 million refugees in camp and non-camp settings Up to 10 technical sections with three core pillars Standards and Indicators Tools and Guidelines Coordination and Support

17 Problem Statement RH component of the HIS in Za atari needed improvement Many contributing factors Transition & consolidation of comprehensive RH services highlighted need for quality RH data Delivery Room in Za atari Camp/UNFPA

18 Za atari Refugee Camp Reproductive Health Surveillance EVALUATION DESIGN

19 Evaluation Objectives

20 Evaluation Objectives Review the RH component of Za atari HIS Review national RH HIS and reporting templates to ensure proposed changes reflect national RH Implement a system for maternal and neonatal mortality audits in Za atari Provide technical support and facilitate implementation of RH component of HIS Develop an action plan to implement the proposed recommendations

21 Evaluation Objectives Review the RH component of Za atari HIS Review national RH HIS and reporting templates to ensure proposed changes reflect national RH Implement a system for maternal and neonatal mortality audits in Za atari Provide technical support and facilitate implementation of RH component of HIS Develop an action plan to implement the proposed recommendations

22 Evaluation Objectives Review the RH component of Za atari HIS Review national RH HIS and reporting templates to ensure proposed changes reflect national RH Implement a system for maternal and neonatal mortality audits in Za atari Provide technical support and facilitate implementation of RH component of HIS Develop an action plan to implement the proposed recommendations

23 Evaluation Objectives Review the RH component of Za atari HIS Review national RH HIS and reporting templates to ensure proposed changes reflect national RH Implement a system for maternal and neonatal mortality audits in Za atari Provide technical support and facilitate implementation of RH component of HIS Develop an action plan to implement the proposed recommendations

24 Evaluation Objectives Review the RH component of Za atari HIS Review national RH HIS and reporting templates to ensure proposed changes reflect national RH Implement a system for maternal and neonatal mortality audits in Za atari Provide technical support and facilitate implementation of RH component of HIS Develop an action plan to implement the proposed recommendations

25 Evaluation Methods

26 Evaluation Methods August 18 to September 14, 2013 Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings Quantitative HIS reproductive health data

27 Evaluation Methods August 18 to September 14, 2013 Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings Quantitative HIS reproductive health data

28 Evaluation Methods August 18 to September 14, 2013 Qualitative Key informant interviews Facility site visits Review of RH documents, tools, and indicators Stakeholder meetings Quantitative HIS reproductive health data

29 Za atari Refugee Camp Reproductive Health Surveillance THE FINDINGS

30 Multiple Non-traditional Health Actors

31 Multiple Non-Traditional Health Actors Varied data collection methods High staff turnover Lack of information sharing

32 Multiple Non-Traditional Health Actors Varied data collection methods High staff turnover Lack of information sharing

33 Multiple Non-Traditional Health Actors Varied data collection methods High staff turnover Lack of information sharing

34 Multiple Non-Traditional Health Actors Varied data collection methods High staff turnover Lack of information sharing Contributed to incomplete & inconsistent reporting

35 Multiple Non-Traditional Health Actors Varied data collection methods High staff turnover Lack of information sharing Contributed to incomplete & inconsistent reporting Reduced data quality

36 Data Quality Weekly HIS Profile Reports

37 Data Quality Weekly HIS Profile Reports Few health actors reported family planning (FP) data

38 Data Quality: Weekly HIS Detailed Reports

39 Data Quality: Weekly HIS Detailed Reports No mechanism to monitor complete postnatal care (PNC)

40 Data Quality: Weekly HIS Detailed Reports No mechanism to monitor complete postnatal care (PNC) No SGBV cases reported

41 Za atari Refugee Camp Reproductive Health Surveillance ACTION PLAN

42 Health Information System Action Plan Standardize RH Data Collection Improve information Sharing Encourage timely submission Train on registers and user guides Develop FP register Development of a RH Tally Sheet

43 Health Information System Action Plan Standardize RH Data Collection Improve information Sharing Encourage timely submission Train on registers and user guides Develop FP register Development of a RH Tally Sheet Pregnancy Card implementation Involve CHWs

44 Health Information System Action Plan Standardize RH Data Collection Improve information Sharing Encourage timely submission Train on registers and user guides Develop FP register Development of a RH Tally Sheet Pregnancy Card implementation Involve CHWs Identify a RH Focal Point within each partner Implement a Mortality Event Review & Response protocol

45 Za atari Refugee Camp Reproductive Health Surveillance LESSONS LEARNED

46 A flexible, systematic approach to data collection and reporting is needed Lessons Learned

47 Lessons Learned A flexible, systematic approach to data collection and reporting is needed Engagement with and training of health actors on key RH data to be collected at different phases

48 Lessons Learned A flexible, systematic approach to data collection and reporting is needed Engagement with and training of health actors on key RH data to be collected at different phases Agreement on and development of a standardized approach to RH data collection at global level

49 Lessons Learned A flexible, systematic approach to data collection and reporting is needed Engagement with and training of health actors on key RH data to be collected at different phases Agreement on and development of a standardized approach to RH data collection at global level Using RH registers early in a crisis highlight key women s health outcomes and guide interventions

50 Provider involvement in development and adoption of tools enhances commitment and collaboration Lessons Learned

51 Lessons Learned Provider involvement in development and adoption of tools enhances commitment and collaboration Data sharing between services provided inside and outside the camps

52 Lessons Learned Provider involvement in development and adoption of tools enhances commitment and collaboration Data sharing between services provided inside and outside the camps Evaluate quality of HIS data early & work with partners to develop and implement an action plan

53 Acknowledgements UNHCR UNFPA Ministry of Health, Jordan Za atari Health Actors - GSF, IMS, IRD, JHAS, MDM, MFH, MSF, RMS, Saudi Clinic CDC Syrian refugee population For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone, CDC-INFO ( )/TTY: cdcinfo@cdc.gov Web: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Center for Global Health Emergency Response and Recovery Branch