Catalogue

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Published on
Dec 31, 1917
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Pages
462
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Language
English
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Addressing the health needs of children in complex emergencies is critical to the success of relief efforts and requires coordinated and effective interventions. However, little systematic work has been undertaken to evaluate such care. To address this need, this monograph presents a review of the published literature in this area, providing background on the burden of disease, the major causes of morbidity and mortality, and the evidence base for effective interventions. It also describes surveys of nongovernmental organizations (NGOs) and international agencies providing care to children in complex emergencies, which were conducted to identify guidelines commonly used to provide such care and assesses the content and limitations of these guidelines. A more in-depth survey of several organizations was also conducted to assess obstacles to this kind of care.

On the basis of the survey findings and the review of the published literature, the working group recommended that evidence-based, locally adapted guidelines to address the curative and preventive care of children in complex emergencies and health systems planning should be adopted by ministries of health and supported by the World Health Organization (WHO) and UNICEF. The guidelines should target, as much as possible, the different levels of health care workers providing care to children to ensure appropriate, effective, and uniform care in a variety of situations.

Child Health in Complex Emergencies presents specific examples of areas for further research and guideline development. This report is not intended to be an exhaustive and definitive assessment of child health in complex emergencies. The topic is much too vast and complex, and different individuals and institutions will have incompatible perspectives. Rather, we aim to provide a starting point for discussion and debate on how to improve the care of children in these settings.
Providing medical support to the local population during a chronic crisis is difficult. The crisis in the Democratic Republic of the Congo (DRC), which is characterized by high excess mortality, ongoing armed violence, mass forced displacement, interference by neighboring countries, resource exploitation, asset stripping, and the virtual absence of the state, has led to great poverty and a dearth of funds for the support of the health system.

International nongovernmental organizations (NGOs) have stepped in to address the dire humanitarian situation. This study looks at four organizations that support local health care in the eastern DRC: the International Rescue Committee (IRC), Malteser, Medical Emergency Relief International (Merlin), and the Association Régionale d'Approvisionnement en Médicaments Essentiels (ASRAMES). The study makes a comparison of the management and financing approaches of these four organizations by collecting and comparing qualitative and quantitative data on their interaction with the (remaining) local health providers and the local population.

Specific objectives of the study are:

1. To identify which management and financing approaches, including the setting of fees, are used by the four NGOs supporting healthcare in the eastern DRC.
2. To determine how these financing approaches affect utilization rates in the health zones supported by the four NGOs.
3. To assess how these utilization rates compare with donor and humanitarian standards.
4. To determine at what level fees must be set to allow for cost recovery or cost sharing in health facilities.
5. To identify the managerial problems confronting the four NGOs.

Many epidemiological and public health studies focus on the interaction between health providers and target groups. Supporting Local Health Care in a Chronic Crisis: Management and Financing Approaches in the Eastern Democratic Republic of the Congo concentrates more on how the relationship between the supporting NGOs and the local health system actually develops. In addition, a common aspect of many of the epidemiological and public health studies is the search for an optimal, or at least appropriate, management and financing approach.
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