During discussions at the 2008 Caribbean Health Disaster Coordinators meeting, and in the framework of PAHO’s Disaster Strategic Plan, participants rallied around the idea of developing a health sector Self-Assessment Tool for Disaster Risk Reduction to evaluate key aspects of disaster risk management (notably mitigation and preparedness). The self-assessment tool was completed in 2009, with significant support from the Canadian International Development Agency. During 2009, it was tested in Trinidad and Tobago, Suriname, and St. Kitts and Nevis. It will be rolled out in at least three other Caribbean countries in the first half of 2010.
This self-assessment tool differs from an external assessment in that it is generally limited to information and data—quantitative and qualitative—available to or generated by the health sector. As a tool for internal use by the health sector, it will aid in determining priorities for a national health sector risk reduction or disaster management program (or set of initiatives) and, if used regularly, as a monitoring tool for measuring changes (or lack thereof) over time.
The construct of the tool is based first on determining the components of mitigation and preparedness from the health sector perspective and their key elements and sub-elements. The sub-elements lead to a selection of both quantitative and qualitative indicators, which provide a comprehensive description of the state or level of the various aspects of mitigation and preparedness in the health sector. In turn, the data needed for the indicators generate a set of questions that comprise the health sector Self-Assessment Tool for Disaster Risk Reduction (DRR).
The components of mitigation and elements that are relevant to the health sector are:
- Risk identification: the key elements are hazard, vulnerability, and risk assessments. These assessments are specific to the health sector as a whole and to individual health sector facilities as opposed to overall national assessments conducted by national disaster agencies. Of course, health sector assessments rely in great part on information and knowledge generated by the latter.
- Soft mitigation activities: land-use planning and building codes are key elements. The sub-elements of each are the national standards and their application within the health sector.
- Hard mitigation activities: New and old facilities are the key elements. The sub-elements are the planning processes leading to the construction of new health facilities, retrofitting activities, and application of the Safe Hospital Program.
The components of preparedness that are relevant to the health sector are:
- Governance: The key elements are the legislative, policy, and structural/systemic frameworks that govern DRR in the health sector.
- Health sector planning: The DRR planning framework, national level health sector plans, and health sector plans at the institution/facility level are the key elements.
- Health sector resources: This component focuses on health sector resources available to deliver the health sector DRR program as opposed to the principal health sector program. Its key elements are material and human resources.
- Health sector public awareness: Pre-event DRR public health awareness and post-event DRR public health information are the two key elements of this component.