Essential health services – control of communicable diseases standard 1: Communicable disease prevention
People have access to information and services that are designed to prevent the communicable diseases that contribute most significantly to excess morbidity and mortality.
Key actions (to be read in conjunction with the guidance notes)
Develop and implement general prevention measures in coordination with relevant sectors (see guidance note 1).
Implement appropriate vector control methods for malaria, dengue and other vector-borne diseases depending on local epidemiology (see guidance notes 2–3).
Implement disease-specific prevention measures, e.g. mass vaccination against measles as indicated (see Essential health services – child health standard 1).
Key indicator (to be read in conjunction with the guidance notes)
Incidences of major communicable diseases relevant to the context are stable (not increasing).
- General prevention measures: This includes good site planning, provision of clean water and proper sanitation, access to hygiene facilities, vaccination against specific diseases, sufficient and safe food supply, personal protection and vector control, and community health education and social mobilisation. Most of these interventions should be developed in coordination with other sectors, including:
shelter – adequate numbers of shelters and sufficient space between them, adequately ventilated, insect-proofed and sited away from standing water, close enough to water and sanitation facilities (see Shelter and settlement standards 1 – standards 2 – standards 3 and Non-food items standard 2).
water, sanitation, hygiene – sufficient quantities of safe water and adequate sanitation facilities and hygiene promotion (see Hygiene promotion standards 1–2, Water supply standards 1–3 and Excreta disposal standards 1–2).
environmental sanitation and safe waste management and vector control (see Guidance notes 2–3, Shelter and settlement standard 4, Vector control standards 1–3, Solid waste disposal standard 1 and Drainage standard 1).
food security, nutrition and food assistance – access to adequate food and management of malnutrition (see Infant and young child feeding standards 1–2, Management of acute malnutrition standards 1–3 and Food security standards 1–3).
health education and social mobilisation – develop messages to ensure the effective implementation of the above preventive measures.
- shelter – adequate numbers of shelters and sufficient space between them, adequately ventilated, insect-proofed and sited away from standing water, close enough to water and sanitation facilities (see Shelter and settlement standards 1 – standards 2 – standards 3 and Non-food items standard 2).
- Malaria prevention: Implementmalaria prevention methods according to the risk of infection, the phase of the emergency and mobility of the population, the type of shelters and behaviour of the local vector in a malaria-endemic region. Vector control measures such as indoor residual spraying (IRS) with an effective insecticide and the distribution of long-lasting insecticide-treated nets (LLINs) should be guided by entomological assessments and expertise. To be effective as a community control measure, IRS requires coverage of at least 80 per cent of dwellings. LLINs provide long-term personal protection and are the standard net of choice. Distributions of untreated nets are not recommended (see Non-food items standard 2 and Vector control standards 1–3).
Prioritisation for LLIN distribution to risk groups depends on the phase of the disaster and level of malaria transmission. In the early phase of disasters in areas of high to moderate malaria transmission, hospital patients, severely malnourished people and members of their households, pregnant women and children under 2 years of age should be prioritised. The next priority is those enrolled in supplementary feeding programmes, children under 5 years of age and households of pregnant women and children under 2 years of age. Eventually, the entire population at risk would require protection with LLINs. In the early phase of disasters in low transmission areas, LLINs should be used in clinical settings (for example, residential therapeutic feeding centres and hospitals).
- Dengue prevention: Vector (larval and adult) control is the main method of dengue prevention. Dengue vector control should be guided by surveillance data on the distribution of human cases and vector density. The most productive breeding sites, which vary from place to place, need to be targeted. In urban areas, Aedes mosquitoes breed in water storage containers and other artificial water accumulation sites (plastic cups, used tyres, broken bottles, flower pots, etc.).Periodic draining and removal of containers is the most effective way of reducing the number of breeding grounds. Water stored in houses should be covered at all times and the containers cleaned and scrubbed weekly. The disaster-affected population should be provided with proper water storage containers with lids. Treatment of containers with an approved larvicide is also effective in eliminating larvae. Spraying with insecticide is effective in reducing the number of adult mosquitoes. Personal protection measures should also be promoted (see Non-food items standard 2 and Vector control standards 1–3).