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Humanitarian Charter and Minimum Standards in Humanitarian Response

Health systems standard 5: Health information management

The design and delivery of health services are guided by the collection, analysis, interpretation and utilisation of relevant public health data.

Key actions (to be read in conjunction with the guidance notes)

Key indicators (to be read in conjunction with the guidance notes)

Guidance notes

  1. Health information system: A surveillance system should build upon the existing HIS whenever possible. In some disasters, a new or parallel HISmay be required. This is determined by an assessment of the performance and adequacy of the existing HIS and the information needs for the current disaster. During the disaster response, health data should include, but not be limited to, the following:
    • deaths recorded by health facilities including under-5 deaths
    • proportional mortality
    • cause-specific mortality
    • incidence rates for most common morbidities
    • proportional morbidity
    • health facility utilisation rate
    • number of consultations/clinician/day.
  2. Sources of data: The interpretation and use of health facility data need to take into account the source of the information and its limitations. The use of supplemental data for decision-making is essential in a comprehensive HIS, for example estimates of prevalence of diseases or information on health-seeking behaviour. Other sources of data that may improve the analysis include population-based surveys, laboratory reports and quality of service measurements. Surveys and assessment must follow internationally recognised quality criteria and use standardised tools and protocols and, where possible, be submitted to a peer-review process.
  3. Disaggregation of data: Data should be disaggregated bysex, age, vulnerability of particular individuals, affected and host populations, and context (e.g. camp versus non-camp situation) as far as is practical to guide decision-making. Detailed disaggregation may be difficult during the early stages of an emergency. However, mortality and morbidity data should at least be disaggregated for children under 5 years old. As time and conditions allow, more detailed disaggregation should be sought to help detect potential inequalities and vulnerable people (see Core Standard 3).
  4. Confidentiality: Adequate precautions should be taken to protect the safety of the individual, as well as the data itself. Staff members should never share patient information with anyone not directly involved in the patient’s care without the patient’s permission. Special consideration should be given to persons with intellectual, mental or sensory impairment, which may compromise their ability to give informed consent. Data that relate to injury caused by torture or other human rights violations including sexual assault must be treated with the utmost care. Consideration may be given to passing on this information to appropriate actors or institutions if the individual gives their informed consent (see Health systems standard 1 and Protection Principle 1, guidance notes 7–12).

See Appendix 2 for sample mortality, EWARNand morbidity monitoring forms. See Appendix 3 for formulas for calculating key health indicators.