Global ClustersCodeSub-domainTitleDescriptionUnit of MeasurementUnit DescriptionDenominatorNumeratorDisaggregationKey indicatorTypesResponse MonitoringStandardsThresholdGuidance on phasesPhase applicabilityGeneral guidanceGuidance for pre-crisis/baselineCommentsData SourcesSector cross-tagging
Food Security;Health;Logistics;Protection;Nutrition;Water Sanitation Hygiene;Camp Coordination / Management;Education;Emergency Shelter and NFI;Emergency Telecommunications;Early RecoveryAAP-1Feedback MechanismsNumber of feedback received (including complaints) which have been acted uponFeedback mechanisms provide a means for all those affected to comment on and thus indirectly influence programme planning and implementation (see HAP’s ‘participation’ benchmark). They include focus group discussions, surveys, interviews and meetings on ‘lessons learnt’ with a representative sample of all the affected population (see ECB’s Good Enough Guide for tools and Guidance notes 3–4). The findings and the agency’s actions in response to feedback should be systematically shared with the affected population.InstitutionNumberN/ANumber of organisations with formal feedback mechanisms in placeYesProcessYesHAP Benchmark 3 on Sharing information, Sphere Core Standard 1: People-centered humanitarian response, The Good Enough Guide - Section 5: Use feedback to improve project impactAll PhasesPre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Feedback mechanisms can take many forms. Whatever the most appropriate channels are should be used; radio talk back programmes, online surveys, sms and twitter inputs, regularised focus group discussions with selected members of the population, suggestions and complaints boxes, designation of sector or camp committees to feedback on specific topics, prioritisation assessments, through dedicated community engagement staff among many other possibilities. Sex, age, ability or other relevant diversity disaggregation of the feedback received is important in order to understand who is most at risk and to take responsible actions. It is important to remember that feedback needs to be collected, digested and acted upon, and then the results of those actions relayed to the population, then another round of feedback can begin on the changed situation. This is the 'feedback loop' - an ongoing dialogue between the humanitarian community and the affected population. Remember that much of this is already happening - through food monitors, community outreach programmes, ongoing assessments - the important thing is to keep the feedback loop continuing.• Clusters and partners have a formal, appropriate feedback mechanism in place that is discussed and agreed with key stakeholders and publicly communicated. • The feedback mechanism employed is appropriate and robust enough to deal with (communicate, receive, process, respond to and learn from) complaints. • Clusters and Lead Agencies/Advisory Groups (SAG) have oversight of feedback (incl. complaints) mechanism and learn from and react to information received. Agencies, NGOs, Government, Media, etc(C) Camp Coordination / Management, C1 Community engagement and self-empowerment, C1.1 Displacement Site Managers, C1.2 CCCM Mechanisms, C2 Population information management, C2.1 CCCM Mechanisms, C2.2 Return/ Relocation/ Integration, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.1 Displacement Site Managers, C3.2 Service Provision - WASH, C3.3 CCCM Mechanisms, C3.4 Service Provision - Protection, C3.5 Service Provision - Food and Nutrition, C3.6 Service Provision - Education, C3.7 Protection, C3.8 Access and Movement, C3.9 Service Provision - WASH &/or Shelter, C3.10 Service Provision - Health, C3.11 Service Provision - Shelter, C4 Camp planning and durable solutions, C4.1 Return/ Relocation/ Integration, (E) Education, E1 Access and Learning Environment, E1.1 Equal Access, E1.2 Facilities and services, E1.3 Protection and Well-being, E2 Teaching and Learning, E2.1 Curricula, E3 Teachers & other education personnel, E3.1 Law and Policy Formulation, E3.2 Recruitment and Selection, E3.3 Supervision, E4 Educational Policy, E4.1 Law and Policy Formulation, (F) Food Security, F1 Food Assistance, F1.1 Cash Transfer, F1.2 Voucher Transfer, F1.3 In-kind Transfer, F1.4 Livelihood Recovery, F2 Livelihood Assistance, F2.1 Cash Transfer, F2.2 Voucher Transfer, F2.3 In-kind Transfer, F3 Food Access, F4 Income Access, F5 Market Access, F6 Availability, F6.1 Food Availability and Agriculture, F6.2 Livestock, F7 Utilization, F8 Agriculture and Livestock, (H) Health, H1 General clinical services & essential trauma care, H2 Child health, H3 Communicable diseases, H4 Sexual and Reproductive Health, H4.1 STI & HIV, H4.2 Maternal and newborn care, H4.3 Sexual violence, H5 Non communicable diseases and mental health, H6 Environmental Health, (L) Logistics, L1 Volume, L2 Weight, (N) Nutrition, N1 Prevention and Management of Acute Malnutrition, N1.1 SAM, N1.2 MAM, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, (P) Protection, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, PC5 Children associated with armed forces and armed groups, PC6 Child Labour, PC7 Unaccompanied and separated children, PC8 Justice for Children, PC9 Community-based child protection mechanisms (CBCPM), P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG2 Develop/apply SOPs context specific, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG4 Advocacy, awareness, education with affected populations, local authorities, international community, PG5 Data collection, storage and sharing, PG6 Prevention Programming, P3 (PL) Housing Land and Property, PL1 HLP Documentation, PL2 Access to Land, PL3 HLP Disputes, PL4 Security of tenure for informal rights holders or vulnerable groups, P4 (PM) Mine Action, PM1 Clearance of Mines and other Explosive Remnants of War (ERW), PM2 Mine and ERW risk education, PM3 Stockpile destruction, PM4 Victim Assistance, P5 Vulnerability, P6 Displacement and Return, P7 Documentation, (R) Early Recovery, R1 Economic Recovery and Livelihoods, R2 Basic Infrastructure Restoration, R3 Capacity Building, R4 Governance, (S) Emergency Shelter and NFI, S1 Shelter, S1.1 Access, S1.2 Assistance, S2 Shelter-related NFI, S2.1 Access, S2.2 Assistance, S3 Shelter-related Fuel/Energy, S3.1 Access, S3.2 Assistance, (T) Emergency Telecommunications, T1 ICT Performance, T2 ETC Coordination, (W) Water Sanitation Hygiene, W1 Hygiene Promotion, W1.1 Hygiene items, W1.2 Hygiene Practices, W2 Water Supply, W2.1 Access and Water Quantity, W2.2 Water Quality, W2.3 Water Facilities, W3 Excreta Disposal, W3.1 Environment, W3.2 Toilet Facilities, W4 Vector Control, W5 Solid Waste Management, W6 Drainage, W7 Aggravating Factors, W8 WASH Programme Design and Implementation
Food Security;Health;Logistics;Protection;Nutrition;Water Sanitation Hygiene;Camp Coordination / Management;Education;Emergency Shelter and NFI;Emergency Telecommunications;Early RecoveryAAP-2Sharing InformationNumber of information products distributed to the affected population through a variety of mechanisms on humanitarian program planning, functioning and progressPeople have a right to accurate and updated information about actions taken on their behalf. Information can reduce anxiety and is an essential foundation of community responsibility and ownership. At a minimum, clusters and agencies should provide a description of the cluster's role and responsibilities, agency’s mandate and project(s), the population’s entitlements and rights, and when and where to access assistance (see HAP’s ‘sharing information’ benchmark). (Sphere Core Standard 1, Guidance Note 4) Possible examples:CommunityNumberN/A# of information messages deliveredYesProcessYesHAP Benchmark 3 on Sharing information, Sphere Core Standard 1: People-centered humanitarian responseAll PhasesPre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Common ways of sharing information include noticeboards, public meetings, schools, newspapers, SMS 'blasts', FAQ flyers or radio and TV broadcasts. The information should demonstrate considered understanding of people’s situations and be conveyed in local language(s), using a variety of adapted media so that it is accessible to all those concerned. For example, use spoken communications or pictures for children and adults who cannot read, use uncomplicated language (i.e. understandable to local 12-year-old) and employ a large typeface when printing information for people with visual impairments. Manage meetings so that older people or those with hearing difficulties can hear. Sex, age, ability or other relevant diversity must be considered when preparing information products as is important in order to understand who is able to access information.• Information about an organisation’s or cluster’s mission, values, legal status and contact details. • Information about projects, plans and activities (in particular beneficiary selection criteria and relevant financial information). • Regular reports of actual performance in relation to previously agreed goals. • Specific details for making comments, suggestions or complaints about the cluster or agency’s activities (preferably a named member of staff). Agencies, NGOs, Government(C) Camp Coordination / Management, C1 Community engagement and self-empowerment, C1.1 Displacement Site Managers, C1.2 CCCM Mechanisms, C2 Population information management, C2.1 CCCM Mechanisms, C2.2 Return/ Relocation/ Integration, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.1 Displacement Site Managers, C3.2 Service Provision - WASH, C3.3 CCCM Mechanisms, C3.4 Service Provision - Protection, C3.5 Service Provision - Food and Nutrition, C3.6 Service Provision - Education, C3.7 Protection, C3.8 Access and Movement, C3.9 Service Provision - WASH &/or Shelter, C3.10 Service Provision - Health, C3.11 Service Provision - Shelter, C4 Camp planning and durable solutions, C4.1 Return/ Relocation/ Integration, (E) Education, E1 Access and Learning Environment, E1.1 Equal Access, E1.2 Facilities and services, E1.3 Protection and Well-being, E2 Teaching and Learning, E2.1 Curricula, E3 Teachers & other education personnel, E3.1 Law and Policy Formulation, E3.2 Recruitment and Selection, E3.3 Supervision, E4 Educational Policy, E4.1 Law and Policy Formulation, (F) Food Security, F1 Food Assistance, F1.1 Cash Transfer, F1.2 Voucher Transfer, F1.3 In-kind Transfer, F1.4 Livelihood Recovery, F2 Livelihood Assistance, F2.1 Cash Transfer, F2.2 Voucher Transfer, F2.3 In-kind Transfer, F3 Food Access, F4 Income Access, F5 Market Access, F6 Availability, F6.1 Food Availability and Agriculture, F6.2 Livestock, F7 Utilization, F8 Agriculture and Livestock, (H) Health, H1 General clinical services & essential trauma care, H2 Child health, H3 Communicable diseases, H4 Sexual and Reproductive Health, H4.1 STI & HIV, H4.2 Maternal and newborn care, H4.3 Sexual violence, H5 Non communicable diseases and mental health, H6 Environmental Health, (L) Logistics, L1 Volume, L2 Weight, (N) Nutrition, N1 Prevention and Management of Acute Malnutrition, N1.1 SAM, N1.2 MAM, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, (P) Protection, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, PC5 Children associated with armed forces and armed groups, PC6 Child Labour, PC7 Unaccompanied and separated children, PC8 Justice for Children, PC9 Community-based child protection mechanisms (CBCPM), P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG2 Develop/apply SOPs context specific, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG4 Advocacy, awareness, education with affected populations, local authorities, international community, PG5 Data collection, storage and sharing, PG6 Prevention Programming, P3 (PL) Housing Land and Property, PL1 HLP Documentation, PL2 Access to Land, PL3 HLP Disputes, PL4 Security of tenure for informal rights holders or vulnerable groups, P4 (PM) Mine Action, PM1 Clearance of Mines and other Explosive Remnants of War (ERW), PM2 Mine and ERW risk education, PM3 Stockpile destruction, PM4 Victim Assistance, P5 Vulnerability, P6 Displacement and Return, P7 Documentation, (R) Early Recovery, R1 Economic Recovery and Livelihoods, R2 Basic Infrastructure Restoration, R3 Capacity Building, R4 Governance, (S) Emergency Shelter and NFI, S1 Shelter, S1.1 Access, S1.2 Assistance, S2 Shelter-related NFI, S2.1 Access, S2.2 Assistance, S3 Shelter-related Fuel/Energy, S3.1 Access, S3.2 Assistance, (T) Emergency Telecommunications, T1 ICT Performance, T2 ETC Coordination, (W) Water Sanitation Hygiene, W1 Hygiene Promotion, W1.1 Hygiene items, W1.2 Hygiene Practices, W2 Water Supply, W2.1 Access and Water Quantity, W2.2 Water Quality, W2.3 Water Facilities, W3 Excreta Disposal, W3.1 Environment, W3.2 Toilet Facilities, W4 Vector Control, W5 Solid Waste Management, W6 Drainage, W7 Aggravating Factors, W8 WASH Programme Design and Implementation
Food Security;Health;Logistics;Protection;Nutrition;Water Sanitation Hygiene;Camp Coordination / Management;Education;Emergency Shelter and NFI;Emergency Telecommunications;Early RecoveryAAP-3ParticipationNumber of persons consulted (disaggregated by sex/age) before designing a program/project [alternatively: while implementing the program/project] Participation in design of assessments, programmes, evaluations etc, means that a selected segment(s) of the affected populaiton have a direct influence on decision making.  Measures should be taken to ensure the participation of members of all groups of affected people – young and old, men and women. Special efforts should be made to include people who are not well represented, are marginalised (e.g. by ethnicity or religion) or otherwise ‘invisible’ (e.g. housebound or in an institution).InstitutionNumberN/Anumber of persons consultedYesProcessYesHAP Benchmark 4 on Participation, Sphere Core Standard 1: People-centered humanitarian response, The Good Enough Guide - Tool 3: How to involve people throughout the projectAll PhasesPre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Understanding and addressing the barriers to participation faced by different people is critical to balanced participation. How a cluster or organisation enables key stakeholders to play an active role in the decision-making processes that affect them. It is unrealistic to expect an organisation to engage with all stakeholders over all decisions all of the time. Therefore the organisation must have clear guidelines (and practices) enabling it to prioritize stakeholders appropriately and to be responsive to the differences in power between them. Mechanisms need to be in place to ensure that the most marginalized and affected are represented and have influence. Participation here also encompasses the processes through which an organisation or cluster monitors and reviews its progress and results against goals and objectives; feeds learning back into the organisation on an on-going basis; and reports on the results of the process. To increase accountability to stakeholders, goals and objectives must be also designed in consultation with those stakeholders. A well known example of participation in developing indicators is the WASH indicator developed by a community which was - "# of hours girls spend in school" - highlighting the importance of education to the community, and also that improved water access had improved education possibilities. So the indicator has a measurement of impact built into it, the improved water access as an outcome can be assumed.• Organisations document how it speaks with a balanced cross-section of representatives from the affected communities. • Agency has a verifiable record of how communities (or their representatives) are demonstrably involved and influential in decision-making, implementation and judgement of impact throughout the lifetime of a project. • Agency has mechanisms in place to monitor and evaluate outcomes and impact and these are reported against (incl. to affected communities). • Cluster has a verifiable record of how it identified interest groups in the affected communities, and the power relationships that exist. Agencies, NGOs, Government(C) Camp Coordination / Management, C1 Community engagement and self-empowerment, C1.1 Displacement Site Managers, C1.2 CCCM Mechanisms, C2 Population information management, C2.1 CCCM Mechanisms, C2.2 Return/ Relocation/ Integration, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.1 Displacement Site Managers, C3.2 Service Provision - WASH, C3.3 CCCM Mechanisms, C3.4 Service Provision - Protection, C3.5 Service Provision - Food and Nutrition, C3.6 Service Provision - Education, C3.7 Protection, C3.8 Access and Movement, C3.9 Service Provision - WASH &/or Shelter, C3.10 Service Provision - Health, C3.11 Service Provision - Shelter, C4 Camp planning and durable solutions, C4.1 Return/ Relocation/ Integration, (E) Education, E1 Access and Learning Environment, E1.1 Equal Access, E1.2 Facilities and services, E1.3 Protection and Well-being, E2 Teaching and Learning, E2.1 Curricula, E3 Teachers & other education personnel, E3.1 Law and Policy Formulation, E3.2 Recruitment and Selection, E3.3 Supervision, E4 Educational Policy, E4.1 Law and Policy Formulation, (F) Food Security, F1 Food Assistance, F1.1 Cash Transfer, F1.2 Voucher Transfer, F1.3 In-kind Transfer, F1.4 Livelihood Recovery, F2 Livelihood Assistance, F2.1 Cash Transfer, F2.2 Voucher Transfer, F2.3 In-kind Transfer, F3 Food Access, F4 Income Access, F5 Market Access, F6 Availability, F6.1 Food Availability and Agriculture, F6.2 Livestock, F7 Utilization, F8 Agriculture and Livestock, (H) Health, H1 General clinical services & essential trauma care, H2 Child health, H3 Communicable diseases, H4 Sexual and Reproductive Health, H4.1 STI & HIV, H4.2 Maternal and newborn care, H4.3 Sexual violence, H5 Non communicable diseases and mental health, H6 Environmental Health, (L) Logistics, L1 Volume, L2 Weight, (N) Nutrition, N1 Prevention and Management of Acute Malnutrition, N1.1 SAM, N1.2 MAM, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, (P) Protection, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, PC5 Children associated with armed forces and armed groups, PC6 Child Labour, PC7 Unaccompanied and separated children, PC8 Justice for Children, PC9 Community-based child protection mechanisms (CBCPM), P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG2 Develop/apply SOPs context specific, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG4 Advocacy, awareness, education with affected populations, local authorities, international community, PG5 Data collection, storage and sharing, PG6 Prevention Programming, P3 (PL) Housing Land and Property, PL1 HLP Documentation, PL2 Access to Land, PL3 HLP Disputes, PL4 Security of tenure for informal rights holders or vulnerable groups, P4 (PM) Mine Action, PM1 Clearance of Mines and other Explosive Remnants of War (ERW), PM2 Mine and ERW risk education, PM3 Stockpile destruction, PM4 Victim Assistance, P5 Vulnerability, P6 Displacement and Return, P7 Documentation, (R) Early Recovery, R1 Economic Recovery and Livelihoods, R2 Basic Infrastructure Restoration, R3 Capacity Building, R4 Governance, (S) Emergency Shelter and NFI, S1 Shelter, S1.1 Access, S1.2 Assistance, S2 Shelter-related NFI, S2.1 Access, S2.2 Assistance, S3 Shelter-related Fuel/Energy, S3.1 Access, S3.2 Assistance, (T) Emergency Telecommunications, T1 ICT Performance, T2 ETC Coordination, (W) Water Sanitation Hygiene, W1 Hygiene Promotion, W1.1 Hygiene items, W1.2 Hygiene Practices, W2 Water Supply, W2.1 Access and Water Quantity, W2.2 Water Quality, W2.3 Water Facilities, W3 Excreta Disposal, W3.1 Environment, W3.2 Toilet Facilities, W4 Vector Control, W5 Solid Waste Management, W6 Drainage, W7 Aggravating Factors, W8 WASH Programme Design and Implementation
HealthH-A.1.aH1 General clinical services & essential trauma careNumber of functional basic health units/10 000 populationProxy indicator of geographical accessibility, and of equity in availability of health facilities across different administrative units. FacilityThe total population for the same administrative or health area, at the same point in timeThe number of basic health units, i.e. all public and private health facilities, defined as a static facility (a designated building) or mobile clinics in which general health services are offered, in a defined administrative or health area, at a given point in timeAdministrative area; health area; public/private; fixed/mobile; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 1: Health service delivery (Key indicator 1)1 Basic Health Unit per 10,000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: Basic health unit is related to the lowest level of health facility at the national level. This indicator can be adjusted to measure the support provided by one or several humanitarian organisations beside the MoH: number of functional basic health units supported by humanitarian organisation/10 000 population. Interpretation: This indicator is a snapshot of the situation at a given point in time. At the pre-crisis phase, this indicator indicates the baseline availability of functional health facilities. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health facilities) when compared to pre-crisis and the needs in terms of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health facilities. Limitation: this indicator measures the availability of health facilities but does not measure access to the facilities by the population nor the quality of service provided. It is therefore only a proxy for coverage.Census of health facilities, administrative boundaries, health areas boundaries, population per administrative areas,and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrument; the indicator itself could be available pre-crisis.Further guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: census of health facilities; assessment of functionality of health facilities; 3 Ws Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, P3 (PL) Housing Land and Property, PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.1.bH1 General clinical services & essential trauma careNumber of functional health centres/50 000 populationProxy indicator of geographical accessibility, and of equity in availability of Health Facilties across different administrative units FacilityThe total population for the same administrative or health area, at the same point in timeThe number of basic health units, i.e. all public and private health facilities, defined as a static facility (a designated building) or mobile clinics in which general health services are offered, in a defined administrative or health area, at a given point in timeAdministrative area; health area; public/private; fixed/mobile; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 1: Health service delivery (Key indicator 1)1 Health Centre per 50 000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: This indicator can be adjusted to measure the support provided by one or several humanitarian organisations beside the MoH: number of health centres supported by humanitarian organisation/50 000 population. Interpretation: This indicator is a snapshot of the situation at a given point in time. At the pre-crisis phase, this indicator indicates the baseline availability of functional health facilities. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health facilities) when compared to pre-crisis and the needs in terms of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health facilities. Limitation: this indicator measures the availability of health facilities but does not measure access to the facilities by the population nor the quality of service provided. It is therefore only a proxy for coverage.Census of health facilities, administrative boundaries, health areas boundaries, population per administrative areas,and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrument; the indicator itself could be available pre-crisis.Further guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: census of health facilities; assessment of functionality of health facilities; 3 Ws Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;F1 Food Assistance, N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.1.cH1 General clinical services & essential trauma careNumber of functional district-rural hospitals/250 000 populationProxy indicator of geographical accessibility, and of equity in availability of Health Facilties across different administrative units FacilityThe total population for the same administrative or health area, at the same point in timeThe number of district/rural hospitals, i.e. all public and private district-rural hospitals, including field hospitals, in a defined administrative or health area, at a given point in timeAdministrative area; health area; public/private; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 1: Health service delivery (Key indicator 1)1 Rural/District Hospital per 250 000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: This indicator can be adjusted to measure the support provided by one or several humanitarian organisations beside the MoH: number of functional rural/district hospitals supported by humanitarian organisation/250 000 population. Interpretation: This indicator is a snapshot of the situation at a given point in time. At the pre-crisis phase, this indicator indicates the baseline availability of functional health facilities. In the early phase after a crisis occurs, this indicator will show the needs in terms of support to health facilities and the consequences of the crisis (decrease/reduction in availability of health facilities) when compared to pre-crisis. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health facilities. Limitation: this indicator measures the availability of health facilities but does not measure access to the facilities by the population nor the quality of service provided. It is therefore only a proxy for coverage.Census of health facilities, administrative boundaries, health areas boundaries, population per administrative areas,and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrument; the indicator itself could be available pre-crisis.Further guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: census of health facilities; assessment of functionality of health facilities; 3 Ws Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;F1 Food Assistance, N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG4 Advocacy, awareness, education with affected populations, local authorities, international community, PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.2H4.2 Maternal and newborn careNumber of functional health facilities with Comprehensive Emergency Obstetric Care (CEmOC) per 500,000 populationProxy indicator for the physical availability and geographical accessibility of emergency obstetric services and their distribution across districts in the affected areas. An unbalance between the availability of BEmOC and CEmOC (with too few BEmOC) is often observed. FacilityThe total population for the same administrative or health area, at the same point in timeNumber of functional health facilities, i.e. all public and private health facilities, with Comprehensive Emergency Obstetric Care in a defined administrative or health area at a certain point in timeAdministrative area; health area; public/private; support/no support from humanitarian organisationsYesBaseline, OutputYesSphere: Essential health services – sexual and reproductive health standard 1: Reproductive health (Key indicator 4)>= 1 health facilities with Comprehensive Emergency Obstetric Care/ 500,000 population; Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: CEmOC includes BEmOC plus caesarian sesction plus safe blood transfusion available 24 hours and 7 days Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of health services but does not measure access to the service by the popualtion nor the quality of service and is therefore only a proxy for coverage. Quality of services (including trained staff and adequate supplies) should be further appraised.Census of health facilities and assessment of service availability should be available pre-crisis through the realisation of SARA or HeRAMS.Further guidance: Monitoring Emergency Obstetric Care (http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/) Numerator: census of health facilities; assessment of functionality of health facilities; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;N2 Infant and Young Child Feeding, P1 (PC) Child Protection, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.2aH4.2 Maternal and newborn careNumber of functional health facility with Basic Emergency Obstetric Care (BEmOC) per 500,000 populationProxy indicator for the physical availability and geographical accessibility of emergency obstetric services and their distribution across districts. An unbalance between the availability of BEmOC and CEmOC (with too few BEmOC) is often observed. FacilityThe total population for the same administrative or health area, at the same point in time Number of functional health facilities, i.e. all public and private health facilities, with Basic Emergency Obstetric Care in a defined administrative or health area at a certain point in time Administrative area; health area; public/private; support/no support from humanitarian organisations YesBaseline, OutputYesSphere: Essential health services – sexual and reproductive health standard 1: Reproductive health (Key indicator 3)>= 4 health facilities with Basic Emergency Obstetric Care/ 500,000 population Follow-up of trends There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: BEmOC includes parenteral antibiotics, oxytocic/anticonvulsant drugs, manual removal of placenta, removal of retained products with manual vacuum aspiration (MVA), assisted vaginal delivery available 24 hours and 7 days Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of health services but does not measure access to the service by the popualtion nor the quality of service and is therefore only a proxy for coverage. Quality of services (including trained staff and adequate supplies) should be further appraised. Census of health facilities and assessment of service availability should be available pre-crisis through the realisation of SARA or HeRAMS. "Further guidance: Monitoring Emergency Obstetric Care (http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/) " Numerator: census of health facilities; assessment of functionality of health facilities; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area; N2 Infant and Young Child Feeding, P1 (PC) Child Protection, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.5H1 General clinical services & essential trauma careNumber of inpatient beds per 10,000 populationIndicator for the availability of hospital beds across crisis areas and proxy indicator of equity in the allocation of resources. BedThe total population for the same administrative or health area, at the same point in timeNumber of inpatient beds in functional health facilities, i.e. all public and private health facilities, in a defined administrative or health area at a given point in timeAdministrative area; health area; public/private; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 1: Health service delivery (Key indicator 1)>10 inpatient beds per 10 000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: this includes total hospital beds (for long-term and acute care), maternity beds and paediatric beds, but not delivery beds. Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of inpatient beds but does not measure access by the popualtion.Number of inpatient beds, administrative boundaries, health areas boundaries, population per administrative areas and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrumentFurther guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: health statistics; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;C2 Population information management, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.10 Service Provision - Health, C3.9 Service Provision - WASH &/or Shelter, N1 Prevention and Management of Acute Malnutrition, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PM4 Victim Assistance, (R) Early Recovery
HealthH-A.6H4.3 Sexual violencePercentage of functional health facilities with clinical management of rape survivor servicesKey indicator to measure the allocation of resources and the availability of services to address consequences of sexual violence. FacilityTotal number of functional health facilities in the same administrative or health area at the same point in timeNumber of functional health facilities, i.e. all public and private health facilities, with clinical management of rape survivors in a defined administrative or health area at a certain point in timeAdministrative area; health area; public/private; support/no support from humanitarian organisationsYesBaseline, OutputYesSphere: Essential health services – sexual and reproductive health standard 1: Reproductive health (Key indicator 1)100% of health facilities with clinical management of rape survivor services Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: should include clinical management of rape survivor plus contraception and PEP as a target. However countries must define which elements of this package are in place to define the locally appropriate monitoring package. Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of health services but does not measure access to the service by the popualtion nor the quality of service and is therefore only a proxy for coverage. Quality of services (including trained staff and adequate supplies) should be further appraised.Census of health facilities and assessment of service availability should be available pre-crisis through the realisation of SARA or HeRAMS.Numerator: assessment of service availability (eg SARA, HeRAMS); Denominator: census of health facilities; assessment of functionality of health facilities;PC3 Sexual violence, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG4 Advocacy, awareness, education with affected populations, local authorities, international community, PG5 Data collection, storage and sharing, PG6 Prevention Programming, P7 Documentation, (R) Early Recovery
HealthH-A.7H1 General clinical services & essential trauma careNumber of health workers per 10,000 populationKey indicator to monitor the availability of health workers. It can serve as a proxy to monitor equity in the allocation of resources by humanitarian actors across different groups within the humanitarian case load and/or crisis affected population versus local populations. IndividualThe total population for the same geographical or health area at a certain point in timeTotal number of health workers (medical doctor + nurse + midwife) in a defined administrative or health area at a certain point in timeAdministrative area; health area; sex of health workers; level of health workers (medical doctor, nurse, midwife); support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 2: Human resources (Key indicator 1)> 22 health workers per 10 000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: health workers include medical doctors, nurses and midwifes Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of work force. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in work force reporting to the facilities) when compared to pre-crisis and the needs in term of support. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. There is no consensus about optimal level of health workers for a population. Limitation: this indicator measures the availability of work force but does not measure the competencies of the work force. Competencies should be further appraised.Number of health workers, administrative boundaries, health areas boundaries, population per administrative areas and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrumentFurther guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: health statistics; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;C2 Population information management, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.10 Service Provision - Health, N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG5 Data collection, storage and sharing, PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.8H1 General clinical services & essential trauma careNumber of Community Health Workers per 10,000 populationIndicator monitoring the availability of human resources key to delivering community-based intervention. IndividualThe total population for the same administrative or health area at the same point in timeTotal number of community health workers in crisis affected areas in a defined administrative or health area at a given point in timeAdministrative Area; health area; sex of community health workers; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standard 2: Human resources (Key indicator 1)>=10 community health workers per 10 000 population Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of work force. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in work force reporting to the facilities) when compared to pre-crisis and the needs in term of support. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of work force but does not measure the competencies of the work force. Competencies should be further appraised.Number of health workers, administrative boundaries, health areas boundaries, population per administrative areas and population per health areas should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrumentFurther guidance: Monitoring the building blocks of the health system (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: health statistics; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas;C2 Population information management, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.10 Service Provision - Health, N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG5 Data collection, storage and sharing, PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.9H1 General clinical services & essential trauma care, H2 Child health, H3 Communicable diseases, H4 Sexual and Reproductive HealthNumber and percentage of functional health facilities providing selected relevant servicesProxy indicator for the physical availability and geographical accessibility of selected services relevant to the local context. FacilityThe total population for the same administrative or health area, at the same point in timeThe number of basic health units, i.e. all public and private health facilities, defined as a static facility (a designated building) or mobile clinics in which general health services are offered, in a defined administrative or health area, at a given point in timeadministrative area; health area; health services; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health systems standardsDepending on services and country; Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: relevant services and package of services should be chosen according to the local context. Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of health services but does not measure access to the service by the popualtion nor the quality of service and is therefore only a proxy for coverage. Quality of services (including trained staff and adequate supplies) should be further appraised.Census of health facilities and assessment of service availability should be available pre-crisis through the realisation of SARA or HeRAMS.Health Resource Availability Mapping System HeRAMS (http://www.who.int/hac/global_health_cluster/guide/tools/en/)Numerator: assessment of service availability (e.g. SARA, HeRAMS); Denominator: census of health facilities; assessment of functionality of health facilities;C2 Population information management, C2.3 Service Provision, C3 Protection and services monitoring and coordination, C3.10 Service Provision - Health, C3.9 Service Provision - WASH &/or Shelter, F1 Food Assistance, N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG5 Data collection, storage and sharing, PG6 Prevention Programming, PM4 Victim Assistance, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.9aH1 General clinical services & essential trauma careNumber and Percentage of non functional health facilitiesIndicator of the consequence of the crisis on the availability of the health services FacilityNumber of health facilities in the same administrative or health area at the same point in time Number of non-functional health facilities in a defined administrative or health area at a given point in time administrative area; health area; type of health facilities, i.e. basic health units, health centres, rural/district hospitals YesBaseline, OutputYesFollow-up of trends There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Phase 1, Phase 2, Phase 3, Phase 4Calculation: A facility is considered non-functional when health care activities cannot take place e.g. because of destruction of building, absence of personnel or no supplies. If some activities can be conducted, even partially and/or non-optimally, the structure is considered functional. Interpretation: This indicator is a snapshot of the situation at a given point in time. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health facilities) when compared to pre-crisis and the needs in terms of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health facilities. Census of health facilities should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrument Numerator: assessment of functionality of health facilities Denominator: census of health facilities N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-A.9bH1 General clinical services & essential trauma careNumber and Percentage of health facilities supported by humanitarian organisationsIndicator of support by health cluster partners beside MoH to the health system; in very disrupted health system can be a proxy for functional health facilities/services as non-supported health facilities have stopped functioningFacilityNumber of health facilities supported by stakeholders other than MoH in a defined administrative or health area at a given point in time Number of health facilities in the same administrative or health area at a given point in time administrative area; health area; type of health facilities, i.e. basic health units, health centres, rural/district hospitals YesBaseline, OutputYesFollow-up of trends There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Phase 1, Phase 2, Phase 3, Phase 4"Calculation: only sustained comprehensive support should be included, e.g. staffing support to run/manage the facility; one-off medicine supplies or equipment, for example, should not be included. Support should be further measured, wherever possible, against established needs as explained under A.1.a and A.1.b Interpretation: this indicator can be used to assess gaps and overlaps in the health response" Census of health facilities should be available for crisis-prone countries, possibly as part of the COD/FOD, as a prepardness instrument Health Resource Availability Mapping System HeRAMS (http://www.who.int/hac/global_health_cluster/guide/tools/en/) Numerator: 3 Ws , Denominator: census of health facilities N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG1 Developing Referral Pathway for Survivors, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-C.1H1 General clinical services & essential trauma careNumber of outpatient consultations per person per year (attendance rate or consultation rate)Proxy indicator for accessibility and utilization of health services that may reflect the quality of services. It does not measure the coverage of this service, but the average number of visits in a defined population. IndividualThe total population for the same administrative or health areaThe number of visits to health facilities, i.e. all public and private health facilities and mobile clinics, for ambulant care in a defined administrative or health area during a yearAdministrative area; health area; age; sex; support/no support from humanitarian organisations;YesBaseline, OutputYesSphere: Health Action chapter, Appendix 3: Formula for calculating Health Facility Utilisation Rate, Sphere: Health systems standard 1: Health service delivery (Key indicator 2)> = 1 new visit/person per year Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: The numerator is defined as the number of visits to health facilities for ambulant care, not including immunization (can be divided into children under five years of age and aged five years and over); The attendance rate is usually calculated annualy. It can be used, nevertheless, to monitor the monthly evolution. In that case, the denominator (target population) should be divided by 12 for keeping the same unit. Interpretation: the patient volumes at outpatient facilities are not a coverage indicator because the population in need is not well defined. Low rates, however, are indicative of poor availability and quality of services. For example, several countries have demonstrated that outpatient department rates go up when constraints to using health services are removed, such as by bringing services closer to the people or reducing user fees. In contrast, once rates exceed a certain threshold the number of visits is no longer an indicator of the strength of the health services.Further guidance: Monitoring the building blocks of the health (http://www.who.int/healthinfo/systems/monitoring/en/index.html)Numerator: routine health facility reporting system; Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas;N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG5 Data collection, storage and sharing, PM4 Victim Assistance, P7 Documentation, W7 Aggravating Factors
HealthH-C.2H1 General clinical services & essential trauma careNumber of consultations per clinician per dayMeasure for the workload and proxy indicator of the quality of care. IndividualNumber of full-time equivalent clinicians in the outpatient departement in the same health facility x number of working days in the same health facility in period of analysisNumber of outpatient consultations in a given health facility during a given period of timeYesBaseline, OutputYesSphere: Health Action chapter, Appendix 3: Formula for calculating the Number of Consultatinos per Clinician per Day, Sphere: Health systems standard 2: Human resources (Key indicator 3)< 50 consultations per clinician per day Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: Numerator: outpatient consultations include new and repeated cases; denominator: a clinician is a health care practitioner that works as a primary care giver in outpatient department. This can include physicians, midwives, nurses and paramedics.Numerator: routine health facility reporting system Denominator: health statisticsN1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, PC1 Dangers and Injuries, PC2 Physical violence and other harmful practices, PC3 Sexual violence, PC4 Psychosocial distress and mental disorders, P2 (PG) Gender-Based Violence, PG3 Multi sectoral engagement (health, legal/justice, security, psychosocial), PG5 Data collection, storage and sharing, PM4 Victim Assistance, P7 Documentation, (R) Early Recovery, W7 Aggravating Factors
HealthH-C.3H5 Non communicable diseases and mental health, H6 Environmental HealthCoverage of measles vaccination (%)Measles coverage refers to the percentage of children who have received at least one dose of measles-containing vaccine in a given year. This indicator is used for estimating the vaccine coverage of the total EPI strategy. To avoid overestimation, measles vaccination coverage is often used as a proxy since it is usually lower than DPT3 coverage. IndividualEstimated total number of children in the target age group in the same administrative or health area in the same period of timeNumber of children in the target age group who received measles vaccination in a defined administrative or health area in a given period of timeAdministrative area; health area; sexYesBaseline, OutputYesSphere: Essential health services – child health standard 1: Prevention of vaccine-preventable diseases (Sphere: 95% irrespective of location)> 95% in camps or urban areas; > 90% in rural areas Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Periodical household vaccination coverage surveys should be considered, particularly following a campaign. Households surveys will be more doable in later phases of the emergency.Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: Measles vaccination coverage can be estimated after a mass vaccination campaign and for EPI; target age group should be determined according to local circumstances. Limitations: The coverage estimates calculated using the administrative method can be biased due to inaccurate numerators or denominators. Numerators may be underestimated (due to incomplete reporting from reporting units or non-inclusion of other vaccinating sources (e.g. private sector, non-governmental organizations), or overestimated (due to over-reporting from reporting units e.g. inclusion of other target groups) Denominator inaccuracies may be due to issues such as: population movement, inaccurate census estimations or projections and/or numerous sources of denominator data Alternatively, vaccination coverage can be estimated by household surveys, where the numerator will be the number of children in a given age range vaccinated and the denominator will be the total number of children in the same age range in the survey.Further guidance: Immunisation coverage (http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf)Numerator: routine health facility reporting system Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas; Alternatively numerator and denominator can be recorded through household surveysN1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, (R) Early Recovery
HealthH-C.4H2 Child healthcoverage of DTP3 in < 1 year old (%)Indicators used for estimating the vaccine coverage of the total EPI strategy. To avoid overestimation, measles vaccination coverage is often used as a proxy since it is usually lower than DTP3 coverage. IndividualEstimated number of infants (under 12 months of age) in the same yearNumber of infants (under 12 months of age) who received DTP3 in a given yearAdministrative area; health area; sexYesBaseline, OutputYesSphere: Essential health services – child health standard 1: Prevention of vaccine-preventable diseases (Key indicator 2) Sphere: 90%>95% Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Periodical household vaccination coverage surveys should be considered, particularly following a campaign. Households surveys will be more doable in later phases of the emergency.Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: DTP3 coverage refers to the percentage of one-year-olds who have received three doses of the combined diphtheria, tetanus toxoid and pertussis vaccine in a given year; Limitations: The coverage estimates calculated using the administrative method can be biased due to inaccurate numerators or denominators. Numerators may be underestimated (due to incomplete reporting from reporting units or non-inclusion of other vaccinating sources (e.g. private sector, non-governmental organizations), or overestimated (due to over-reporting from reporting units e.g. inclusion of other target groups) Denominator inaccuracies may be due to issues such as: population movement, inaccurate census estimations or projections and/or numerous sources of denominator data Alternatively, vaccination coverage can be estimated by household surveys, where the numerator will be the number of children in a given age range vaccinated and the denominator will be the total number of children in the same age range in the survey.Further guidance: Immunisation coverage (http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf)Numerator: routine health facility reporting system Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas; Alternatively numerator and denominator can be recorded through household surveysN1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, P1 (PC) Child Protection, (R) Early Recovery
HealthH-C.5H4.2 Maternal and newborn carePercentage of births assisted by a skilled attendantProxy measure for the utilization rate of obstetrics services in health facilities and in communities where Village-Trained Midwives are operating. It is a measure of a health system?s ability to provide adequate care for pregnant women during labour and delivery. IndividualEstimated total number of births in the same administrative or health area in the same period of timeNumber of births in a defined administrative or health area in a given period of timeAdministrative area; health areaYesBaseline, OutputYes>90% Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Periodical household surveys should be considered. Households surveys will be more doable in later phases of the emergency.Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: Numerator: A skilled birth attendant is an accredited health professional ? such as a midwife, doctor or nurse ? who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns. Traditional birth attendants, trained or not, are excluded from the category of skilled attendant at delivery. Denominator should be calculated by using the fertility rate by age class and region (e.g. obtained via demographic and health surveys). In Sub-Saharan Africa, for instance, the expected proportion of births is between 4 and 5 % of the total population. Alternatively, percentage of births assisted by a skilled attendant can be assessed through household surveys where the numerator is the number of reported deliveries over a certain period of time assisted by a skilled attendant and the denominator is the reported number of births over the same period of time. Interpretation: This indicator can serve as a proxy for monitoring progress in the health response. Limitations: the indicator may not sufficiently capture women?s access to high quality care, particularly when complications arise. It also does not provide information on availability of any supplies and equipment a skilled attendant may need. Both administrative and household survey methods have limitations. The calculation of the number of births from administrative population number and fertility rates can be very imprecise. Reporting bias in houshold surveys can lead to imprecision in the estimate.Further guidance: monitoring maternal and newborn child health (http://www.who.int/healthmetrics/news/monitoring_maternal_newborn_child_health.pdf) Numerator: routine health facility reporting system Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas; fertility rate (from DHS, for example) Alternatively numerator and denominator can be recorded through household surveysN2 Infant and Young Child Feeding, P1 (PC) Child Protection, (R) Early Recovery, W7 Aggravating Factors
HealthH-C.6H4.2 Maternal and newborn carePercentage of deliveries by caesarean sectionThe proportion of all deliveries by caesarean section in a geographical area is a measure of access to and use of a common obstetric interventions for averting maternal and neonatal deaths and for preventing complications such as obstetric fistula. Of all the procedures used to treat major obstetric complications, caesarean section is one of the commonest, and reporting is relatively reliable. IndividualEstimated total number of births in the same administrative or health area in the same period of timeNumber of births by Caesarean section in a defined administrative or health area in a given period of timeAdministrative area; health area;YesBaseline, OutputYesSphere: Essential health services – sexual and reproductive health standard 1: Reproductive health (Key indicator 5)>=5% and <=15% of deliveries by ceasarian section Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Periodical household surveys should be considered. Households surveys will be more doable in later phases of the emergency.Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: Denominator should be calculated by using the fertility rate by age class and region (e.g. obtained via demographic and health surveys). In Sub-Saharan Africa, for instance, the expected proportion of births is between 4 and 5 % of the total population. Alternatively, percentage of deliveries by Caesarean section can be assessed through household surveys where the numerator is the number of reported deliveries by Caesarian section over a certain period of time and the denominator is the reported number of births over the same period of time. Interpretation: This indicator can serve as a proxy for monitoring progress in the health response. Limitations: Both administrative and household survey methods have limitations. The calculation of the number of births from administrative population number and fertility rates can be very imprecise. Reporting bias in houshold surveys can lead to imprecision in the estimate.Further guidance: Monitoring Emergency Obstetric Care (http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/) Numerator: routine health faicility reporting system; Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas; fertility rate (from DHS, for example) Alternatively numerator and denominator can be recorded through household surveysN2 Infant and Young Child Feeding, P1 (PC) Child Protection, (R) Early Recovery, W7 Aggravating Factors
HealthH-R.1H3 Communicable diseases, H5 Non communicable diseases and mental healthIncidence for selected diseases relevant to the local contextUseful measure of the burden of diseases and detect outbreaks. The list of diseases is context specific and can include communicable and non-communicable diseases. IndividualTotal population in the same administrative or health area and at the same time periodNumber of cases of selected disease in a defined administrative or health area in a given period of timeAdministrative area; health area; age (usually < 5 years; >= 5 years)YesBaselineYesThresholds for alert/outbreak depending on disease Follow-up of trendsThere is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Calculation: incidence rate, i.e. number of cases per pers per time period, should be calculated, especially when large population movement occurs; however, in many settings, accurate calculation of incidence is severely limited by inaccurate population data, and total number of cases seen should be used instead. Proportional morbidity (cases of disease divided by total cases and expressed as a percentage) is also useful when the population denominators are unknown or changing. Interpretation: can be used both for detection of outbreaks and for monitoring of the effect of the health response. Limitations: Health facility surveillance may have low sensitivity for conditions that do not commonly go to clinic. Access to health services is another factor.Further guidance: Outbreak surveillance and response in humanitarian emergencies (http://whqlibdoc.who.int/hq/2012/WHO_HSE_GAR_DCE_2012_1_eng.pdf)Numerator: EWARS, health facility based surveillance, routine health facility reporting system Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas;N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, (R) Early Recovery, S1 Shelter, S2 Shelter-related NFI, W7 Aggravating Factors
HealthH-R.3H3 Communicable diseases, H5 Non communicable diseases and mental healthCase Fatality Ratio (CFR) for most common diseasesProbability of dying as a result of a given disease. Is a result of a mixture of disease severity and quality of health care.IndividualTotal number of cases related to the disease in the same administrative or health area and the same time period Total number of fatalities related to the disease in a defined administrative or health area in a given time period Administrative area; health area; sex YesBaselineYesSphere: Essential health services – control of communicable diseases standard 3: Outbreak detection and response (Key indicator 4)Cholera : 1 per cent or lower; Shigella dysentery : 1 per cent or lower; typhoid : 1 per cent or lower; meningococcal meningitis : varies, 5-15 per cent; malaria : varies, aim for <5 per cent in severely ill malaria patients; measles : varies, 2-21 per cent reported in conflict-affected settings, aim for <5 per cent. Follow-up of trends There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc... Pre-crisis/Baseline, Phase 1, Phase 2, Phase 3, Phase 4Interpretation: the CFR is an indicator of the quality of case management, late arrival at the facility or severity of disease. Limitations: most likely to be biased upwards because only more severe cases normally go to clinics. Further guidance: IDSR guide CDC Afro. NB: This indicator is relevant to WASH only for certain diseases. (http://www.cdc.gov/globalhealth/dphswd/idsr/pdf/Technical%20Guidelines/IDSR%20Technical%20Guidelines%202nd%20Edition_2010_English.pdf) Numerator: health facility based surveillance; routine health facility reporting system Denominator: health facility based surveillance; routine health facility reporting system N1 Prevention and Management of Acute Malnutrition, N2 Infant and Young Child Feeding, N3 Prevention and Control of Micronutrients Deficiencies, (R) Early Recovery, S1 Shelter, S2 Shelter-related NFI, W7 Aggravating Factors