2.3 Prioritize child and adolescent health interventions
Humanitarian emergencies typically increase the health needs of populations while at the same time disrupting the capacity of existing services to respond. Humanitarian responders must quickly identify the biggest health needs (including populations at very high risk), and decide actions to prioritize1.
Prioritization aims to bring the greatest benefit to the greatest number of people (Box 10). In practice, this means confronting the biggest causes of death and disability with the most cost-effective tools and providing extra attention to populations at high risk. This requires balancing the desire to provide more services against the desire to reach more people with the available resources and workforce. It also requires consideration of the practical feasibility of interventions in particular contexts.
The RMNCAH/CAH working group should assist the lead health agency to prioritize services (maternal and child health will always need to be a high priority). See Annex 4 for a list of priority health issues and interventions for consideration. Action area 3 (Respond) describes each action in more detail.
Box 10 Principles for prioritizing actions
- The goal of prioritization is to prevent the greatest suffering and loss of life. Priority actions will vary between contexts (e.g. displacement versus famine) and will change over time.
- Certain child populations are at high risk of suffering and loss of life, and will therefore require particular attention (e.g. young children, girls, children with disabilities ).
- Prioritization requires balancing (i) the desire to provide more services with (ii) the desire to reach more people using available resources.
Key actions – prioritization
Adapted from the Sphere Health Standards (1)
- The health cluster lead should coordinate the systematic prioritization of health services and activities. Child health will always be a high priority, but the RMNCAH/CAH working group (and individual organizations) should advocate strongly for newborn, child and adolescent issues.
- In cooperation with the health cluster lead, the RMNCAH working group(s) reviews findings from the needs assessment and pre-crisis morbidity and mortality data to identify the main health threats. Review findings from the service availability assessment to decide what is feasible. Review priorities from the all hazards risk assessment (or other similar preparedness plans). Ensure that child and adolescent health is reflected in humanitarian needs overview and humanitarian response plans.
- Analyse which interventions will have maximum impact to reduce morbidity and mortality . Prioritize:
- the most likely and largest causes of excess morbidity and mortality,
- the population groups most affected,
- the most effective interventions in reducing morbidity and mortality, and
- the most feasible interventions.
- Take care to assess needs and capacities of those in hard-to-reach locations and at-risk groups (e.g. people with disabilities, young children and adolescents ), and develop strategies to include them in the humanitarian response.
- Identify barriers that impede access to prioritized CAH health services and look for practical solutions to tackle them.
- Repeat the prioritization exercise as the response evolves, to assess and deal with any changes in health needs. Frequency should be decided jointly with the ministry of health, or lead agency, and all health partners.
Key indicators
- The RMNCAH/CAH working group and health cluster lead have produced a document explaining the identified CAH priorities, and disseminate it to health actors.