Complex, Humanitarian Emergencies: III. Measures of Effectiveness

Burkle, Frederick M.; McGrady, Katherine; Newett, Sandra L.; Nelson, John J.; Dworken, Jonathan T.; Lyerly, William H.; Natsios, Andrew S.; Lillibridge, Scott R.

doi:10.1017/s1049023x00041662

Cited by 41 publications

(23 citation statements)

References 4 publications

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“…Project management tools such as the logical framework and other related approaches, such as use of agreed measures of effectiveness, could become helpful disaster management tools in complex emergencies. 27 37…”

Section: Encouraging Evidence Based Practicementioning

confidence: 99%

Conflict and health: Public health and humanitarian interventions: developing the evidence base

Banatvala

Zwi²

2000

BMJ

125

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Worldwide, millions of people are annually affected by conflict and over $2bn was spent on non-food emergency aid each year between 1991 and 1997. 1 Recently, 30 million people were estimated to be internally displaced and 23 million to be refugees (seeking refuge across international borders), the vast majority of whom were fleeing conflict zones. 2 More agencies than ever are working in relief activities; over 200 humanitarian agencies responded to the Rwandan genocide and population displacement. 3 Populations affected by armed conflict experience severe public health consequences as a result of food insecurity, population displacement, the effects of weapons, and the collapse of basic health services. 4 5 Though most conflicts after the second world war took place in Africa, the Middle East, Asia, and Latin America, since the end of the Cold War and break up of the Soviet Union we have also witnessed conflicts in Europe and the former Soviet Union, notably in Tajikistan, Chechnya, former Yugoslavia, and NagornoKarabakh. 6 Increasingly, with relatively few exceptions, conflicts are internal rather than waged between states.This article argues that the evidence base for humanitarian health interventions should be actively developed and explores mechanisms for its promotion.

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Section: Encouraging Evidence Based Practicementioning

confidence: 99%

Conflict and health: Public health and humanitarian interventions: developing the evidence base

Banatvala

Zwi²

2000

BMJ

125

View full text Add to dashboard Cite

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“…[1][2][3] The provision of such care rarely is documented in peer-reviewed journals, and outcome indices and measures of effectiveness, while generally applied to medical interventions, have not been applied to these settings. [4][5][6] Recently, the World Health Organization (WHO) reported a severe shortage of healthcare workers in 57 developing countries. For example, Sub-Saharan Africa has 11% of the Application of Outcome Measures An unknown number of surgical interventions are provided throughout the developing world by personnel from charitable and religious organizations, volunteer aid organizations, and well-established, funded organizations.…”

Section: Introductionmentioning

confidence: 99%

Application of Outcome Measures in International Humanitarian Aid: Comparing Indices through Retrospective Analysis of Corrective Surgical Care Cases

McQueen

Magee

Crabtree

et al. 2009

Prehosp. Disaster med.

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It is common for international organizations to provide surgical corrective care to vulnerable populations in developing countries. However, a current worsening of the overall surgical burden of disease in developing countries reflects an increasing lack of sufficient numbers of trained healthcare personnel, and renders outside volunteer assistance more desirable and crucial than ever. Unfortunately, program evaluation and monitoring, including outcome indices and measures of effectiveness, is not measured commonly. In 2005, Operation Smile International implemented an electronic medical record system that helps monitor a number of critical indices during surgical missions that are essential for quality assurance reviews. This record system also provided an opportunity to retrospectively evaluate cases from previous missions. Review of data sets from >8,000 cases in 2005 and 2006 has provided crucial information regarding the priority of surgery, perioperative and operative complications, and surgical program development.The most common procedure provided was unilateral cleft lip repair, followed closely by cleft palate. A majority of these interventions occurred for patients who were older than routinely provided for in the western world. The average child treated had an age:weight ratio at or below the [US] Centers for Disease Control and Prevention (CDC) 50th percentile, with a small percentage falling below the CDC 20th percentile. A majority of children had acceptable levels of hemoglobin, but the relative decreased age:weight ratio nonetheless can reflect mild malnutrition. Complications requiring medical intervention were seen in 1.2% of cases in 2005 and 1.0% in 2006. Thirty percent were reported as anesthesia complications, and 61% reported as surgical complications. One death was reported, but occurred after discharge outside the perioperative period. Complication rates are similar to rates reported in the US and UK and emphasizes the importance of standardization with uniform indices to compare quality performance and equity of care. This study offers an important example of the importance of collecting, analyzing, and reporting measures of effectiveness in all surgical settings.

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“…69 MOE also need to be measured more than once to be meaningful and show progress, or lack of it, toward mission accomplishment. 69 Similarly, the development of the International Search and Rescue Advisory Group (INSARAG), 70 has been achieved by a response element with more clearly defined roles and leadership. This has enabled development of accepted networks and international classification.…”

Section: Discussionmentioning

confidence: 99%

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

Aitken

Leggat

Robertson

et al. 2012

Prehosp. Disaster med.

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In this study of Australian DMAT members, there was unanimous support for a clear command structure in future deployments, with clearly defined team roles and reporting structures. This should be supported by clear identification of team leaders to assist inter-agency coordination, and by leadership training for DMAT commanders. Members of Australian DMATs would also support the development and implementation of meaningful, evidence-based standards. More work is needed to identify or develop actual standards and the measures of effectiveness to be used, as well as the contents and nature of leadership training.

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Complex, Humanitarian Emergencies: III. Measures of Effectiveness

Cited by 41 publications

References 4 publications

Conflict and health: Public health and humanitarian interventions: developing the evidence base

Conflict and health: Public health and humanitarian interventions: developing the evidence base

Application of Outcome Measures in International Humanitarian Aid: Comparing Indices through Retrospective Analysis of Corrective Surgical Care Cases

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

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