To facilitate the assessment process the following areas are considered:

2.1 Basic country profile oriented to disaster situations
2.2 General overview of the health sector
2.3 Health disaster preparedness program

For each of these areas, the assessment team's approach to information gathering should include:

a) Objectives of the assessment
b) Checklist of basic indicators
c) Key issues to be raised
d) Appropriate sources of information
e) Summary of findings

The assessment of the basic country profile (2.1), and general overview of the health sector (2.2), should be made in general terms. The health disaster preparedness program (2.3) should be assessed in more depth. It is, therefore, more appropriate to separate the components, as presented below.

For the purpose of these guidelines, let us assume that the team members responsible for the assessment are familiar with the health field and with disaster management issues.

2.1 Basic country profile

Objectives:

A country profile enables the team to become familiar with the general characteristics of the country in which the assessment will take place. Information should be made available to team members prior to their country visit.

If a disaster profile is not easily available, especially in less developed countries, basic information must be gathered in order to:

· Identify the most frequent natural, technological, and man-made disasters;
· Determine the vulnerability of the population;
· Determine the existing resources.

Checklist of basic indicators:

· Data collection on major past disasters
· Distribution of population in high-risk areas (mapping for natural and technological disasters)
· Land use and settlements
· Community involvement in disaster preparedness and response

Key questions:

· Which institutions are in charge of collecting information on past disasters? Where are they located? What information is available?

· Are there laws or regulations regarding human settlements in risk areas? Which institutions are involved?

· How effective is community participation in disaster preparedness and response? How are communities organized in the most vulnerable areas?

Sources of information:

Civil Defense or National Emergency Committee, Ministry of Agriculture, meteorological agencies, Ministry of Housing, and others.

Summary of findings:

A brief summary should reflect an analysis of the findings and special attention should be paid to the extent of vulnerability and of the potential population at risk.

2.2 General overview of the health sector

Objectives:

Basic information should be collected in order to become acquainted with organization and structure of the country's health system.

This section deals only with issues. The disaster preparedness program's components, functions, or specific contingency plans are covered in Chapter 3.

The information gathered on key elements of the health sector will allow us:

· To identify the health sector's response capability in disaster situations;
· To make an inventory of the participating institutions in disaster preparedness and relief;
· To determine the health system's coverage of populations in urban and/or rural areas.

Checklist of basic points:

· National health policy and legislation for disasters

· Organization of the health sector at the national, regional, and local levels

· Organization and structure of the Ministry of Health in terms of coping with disaster situations,

Key questions:

· Is there a national health policy regarding disaster preparedness and relief?

· To what degree are the health authorities committed to promoting disaster preparedness?

· What types of legal provisions exist?

· Have building codes been adopted at the national level for design and construction techniques that will reduce the effects of natural hazards in health care facilities?

· How is the health system organized at the national, regional, and local levels?

· Is there an office or technical unit within the Ministry of Health in charge of promoting, developing, and coordinating disaster preparedness activities?

· Where is it located in the organizational chart? What level of authority has been delegated to this office?

· Does the technical unit located in the Ministry of Health have a budget for the development of activities? What percent does this represent of the total Ministry of Health's budget?

· Are there special provisions for using these funds in an emergency situation?

· Is the officer charge of the unit a full-time or part-time employee?

· How many health institutions participate in disaster preparedness activities?

· How are these institutions distributed at the national, regional, and local levels?

· Do health institutions have designated officers in charge of disaster preparedness activities at each level?

Sources of information:

Information should be collected by direct interview with the health authorities of the Ministry of Health, selected UN agencies, and from executives of main governmental and private institutions and other organizations providing health services nationwide.

Due to time limitations, it may be necessary to prepare a concise questionnaire which should he filled in by authorities.

Following the eruption of Nevado del Ruiz in Colombia, the injured had to be airlifted to health facilities in neighboring cities. (Photo: Vizcarra, PAHO/WHO)

Summary of findings:

The collected information must be analyzed. Particular attention should be paid to the Ministry of Health's organization and structure, budget, and potential response capacity. A list of health institutions, organizational charts, and available infrastructure can be attached to the evaluation document.

2.3 Health disaster preparedness program

The assessment team should dedicate time and special attention to the evaluation of the health sector's disaster preparedness program components and activities. It should also note the interdisciplinary activities in the health field and the intersectoral nature of the program.

The main objectives of this aspect of the assessment are:

· To determine the level of complexity of the national program;

· To define the quality of its technical development;

· To determine the response capacity and degree of authority for resources, mobilization, and coordination;

· To define the level of involvement and training of human resources.

Sources of information:

In addition to the information provided by the Ministry of Health's counterparts, other sources must be considered. It is advisable to maintain direct contact with people actually involved in or familiar with a specific area. When assessing hospital disaster preparedness, on-site visits and walk-through activities must be considered.