Organization:HeRAMS

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Short description: Electronic system for monitoring medical resources

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HeRAMS (Health Resources Availability Mapping System) is an electronic system for monitoring medical resources, a WHO tool for standardizing and assessing the availability of medical services, mostly used for emergency response.[1][2] This method to date has mostly been implemented as cross-sectional surveys, but should instead be used as a real-time monitoring system.[3] Acute and protracted crises have grave immediate and long-term effects on population health and health systems, which is particularly evident in low-income countries. Assessing the availability of health services is essential in understanding the disrupted health systems' capacities and weaknesses. HeRAMS enables health sector stakeholders to make managerial decisions and to implement effective planning in the field of health care in time, especially crucial during humanitarian emergencies or healthcare optimization.[1][4] These decisions save lives and reduce suffering, especially in response to emergencies. Health sector evaluations assessing the effectiveness and applicability of HeRAMS were conducted in Sudan,[4][5][6] Mali,[7] Philippines ,[8] Central African Republic,[9][10] Syria,[11] Fiji,[12][1][13] Nigeria,[14] Yemen,[15][2] Iraq[16] and Ukraine .[17][18]

General information

The need to identify the right investments in health development, corresponding with public health demands is one of the most pressing global public health challenges.[19] The significant gaps in the availability of essential health information still existed in recent, large, armed conflicts and natural disasters.[20] HeRAMS was developed by WHO and the Global Health Cluster (the humanitarian cluster approach is the main coordination mechanism for crises: in the case of crises usually one humanitarian cluster is activated for each sector of the response — eg, nutrition, health or WASH).[3]

When conducting programs using HeRAMS, information is collected about each health facility in a specific area. Then the analysis of the received data is carried out.[2] Updating and georeferencing the database of health facilities in the crisis-affected area is a key step in HeRAMS implementation. It should arguably be done as part of emergency preparedness. It is also needed for health management information systems.[3]

HeRAMS data need to be updated a few times. These information will provide a guide to the progress of reconstruction and revitalization of health facilities.[21]

Based on the findings, WHO, in collaboration with local health ministries, makes analytical reports and develops possible measures to improve the situation.[2] The approach allows to display data on a geographic background. This visualization helps to better understand the situation. It is possible to find the gaps in the medical system that are invisible under the usual approach. Such an opportunity to show a deep understanding of the state of affairs promotes effective communication with stakeholders.[1]

HeRAMS in Nigeria

With the Boko Haram insurgency and the later activation of the conflict in 2013, the humanitarian crisis has been continuing in the northeast part of Nigeria since then.[22] In 2016 WHO started initial assessments in Borno State with local Ministry of Health.[14][23][24] Previously HeRAMS has been conducted in Adamawa and Yobe states.[21][25] WHO planned to update the HeRAMS data three times in 2017/8 across these tree states. This information will lead to a more effective recovery of the medical infrastructure.[21]

In 2017 in Adamawa 1120 health facilities were assessed, which included 1 tertiary and 28 secondary hospitals, 363 primary health care centers and 336 primary health care clinics. 12% of them were completely destroyed, 34% – partially damaged and 54% – not damaged. 20% of the 379 partially damaged facilities were fully functional, 63% were partially functional, and 16% were non-functional.[26][27]

The Yobe State survey, conducted in 593 health facilities, including 2 tertiary hospitals, 16 secondary ones and 113 primary health care centers, showed that 10% of them were completely destroyed. 70% of the partially damaged (183) and undamaged (347) facilities were fully functional and 17% were partially functional.[27]

The worst situation was in Borno State. According to HeRAMS findings on 2017 about 35% of the 743 health facilities were completely destroyed, about 30% were partially damaged.[24][21][28] Significant water supply problems were also identified: three-fourths of facilities did not have a sufficient number of appropriate disinfectants, more than half did not have safe water access.[22][29]

HeRAMS in Yemen

Yemen is in ongoing conflict that began in 2015[30] HeRAMS assessment in 2016 covered 3,507 facilities in 16 governorates.[31][32] 45% of the surveyed health facilities were fully functional.[15]

HeRAMS in Iraq

During Mosul crisis in 2017 five teams from Ninewa Directorate of Health were selected from east Mosul, Qayara and Al-Hamdaniya districts. They were trained on HeRAMS for assessing availability of medical resources and services in the healthcare facilities within the area of their origin.[16]

253 healthcare facilities were surveyed. According to collected data, published in analytical report in 2018, 14% of health houses, 22% of primary health care centres and 48% of referral hospitals were not-functioning. But all 5 field hospitals were fully functioning and most of mobile medical clinic were fully or partially functioning.[33][34]

HeRAMS in Ukraine

In response to prolonged military intervention, in Ukraine a new Ministry of Temporarily Occupied Territories was founded and central units of the executive branch of Ukraine created relevant divisions. In the Ministry of Social Policy operates Divilion for social adaptation of ATO participants and retired servicemen,[35] in the Ministry of Health – Division of coordination and providing medical care during anti-terrorist operations, emergency and martial law.[36]

In cooperation with it World Health Organization launched the HeRAMS Ukraine project in 2017. Primarily initial assessment was conducted only on the territory of Donetsk and Luhansk regions.[17][18][37]

References

  1. ↑ 1.0 1.1 1.2 1.3 "GIS mapping is saving lives in Fiji. (Talk with RedR GIS-specialist Paul Jaskierniak, who played a central role in the World Health Organization's key decision following Cyclone Winston)". RedR Australia. 1 June 2016. https://www.redr.org.au/in-the-field/field-stories/gis-mapping-is-saving-lives-in-fiji/. 
  2. ↑ 2.0 2.1 2.2 2.3 "Health Resources Availability Monitoring System (HeRAMS)". WHO. https://www.who.int/hac/herams/en/. 
  3. ↑ 3.0 3.1 3.2 Checchi, Francesco; Warsame, Abdihamid; Treacy-Wong, Victoria; Polonsky, Jonathan; Ommeren, Mark van; Prudhon, Claudine (November 2017). "Public health information in crisis-affected populations: a review of methods and their use for advocacy and action". The Lancet 390 (10109): 2297–2313. doi:10.1016/S0140-6736(17)30702-X. PMID 28602558. https://researchonline.lshtm.ac.uk/4189871/2/Public%20health%20information%20in%20crisis-affected%20populations_GREEN_Webappendix_FINAL.pdf. 
  4. ↑ 4.0 4.1 Nickerson, Jason W.; Hatcher-Roberts, Janet; Adams, Orvill; Attaran, Amir; Tugwell, Peter (2015). "Assessments of health services availability in humanitarian emergencies: a review of assessments in Haiti and Sudan using a health systems approach". Conflict and Health 9 (20): 20. 8 June 2015. doi:10.1186/s13031-015-0045-6. PMID 26106443.  CC-BY icon.svg Material was copied from this source, which is available under a Creative Commons Attribution 4.0 International License.
  5. ↑ "HeRAMS Sudan: Annual report 2013". WHO. http://www.emro.who.int/images/stories/sudan/documents/special_reports/herams_annual_2013.pdf?ua=1. [|permanent dead link|dead link}}]
  6. ↑ "Sudan: Health Resources Availability Mapping System (HeRAMS)". OCHA. July 4, 2010. https://reliefweb.int/report/sudan/sudan-health-resources-availability-mapping-system-herams. 
  7. ↑ "HeRAMS Mali – executive summary". WHO. December 2013. https://www.who.int/hac/crises/mli/executive_summary_herams_mali_18december2013.pdf. 
  8. ↑ "Typhoon Yolanda: One Year On photo story". WHO. http://www.wpro.who.int/philippines/mediacentre/features/typhoon_yolanda_one_year_on_main/en/. 
  9. ↑ "RCA-WHO- Rapport de l'enquête HeRAMS 2016". OCHA. https://www.humanitarianresponse.info/en/operations/central-african-republic/document/rca-health-resources-availability-monitoring-system. 
  10. ↑ "Central African Republic Special Information Brief 9 Months after L3 Declaration - 15 September 2014". OCHA. September 15, 2017. https://reliefweb.int/report/central-african-republic/central-african-republic-special-information-brief-9-months-after-l3. 
  11. ↑ "Syrian Arab Republic. HeRAMS". WHO. http://www.emro.who.int/syr/herams/index.html. 
  12. ↑ "Saving lives in Fiji with our Standby Partners". WHO. https://www.who.int/hac/standby_partnerships/redrfiji21072016/en/. 
  13. ↑ "WASH in Health Care Facilities: Fiji Experience". UNICEF. https://www.washinhcf.org/fileadmin/user_upload/documents/WASH-in-Health-Care-Facilities-presentation-Fiji.pdf. 
  14. ↑ 14.0 14.1 "Information on health services essential for humanitarian response in Borno State, Nigeria". WHO. November 2016. https://www.who.int/features/2016/health-services-nigeria/en/. 
  15. ↑ 15.0 15.1 "Survey reveals extent of damage to Yemen's health system". OCHA. November 6, 2016. https://reliefweb.int/report/yemen/survey-reveals-extent-damage-yemens-health-system. 
  16. ↑ 16.0 16.1 "WHO Special Situation Report, Mosul Crisis, Iraq, Issue No 12: 26 March to 01 April 2017". WHO. April 2017. http://www.emro.who.int/images/stories/iraq/WHO_Special_Situation_Report_on_Mosul_Crisis_26_March_to_01_April_2017.pdf. [|permanent dead link|dead link}}]
  17. ↑ 17.0 17.1 "Monitoring of medical resources under the HeRAMS Ukraine program". Selydove city council. December 2, 2017. http://selidovo-rada.gov.ua/novini/monitoring-medichnikh-resursiv-za-programoyu-herams-ukraine. 
  18. ↑ 18.0 18.1 "Work of employees of the Department of Health of the Regional State Administration for 10 months of 2017" (in uk). Department of Health of Donetsk Regional State Administration. 6 December 2017. https://doz.donoda.gov.ua/robota-spivrobitnikiv-upravlinnya-organizatsiyi-ta-rozvitku-medichnoyi-dopomogi-naselennyu-departamentu-ohoroni-zdorov-ya-oblderzhadministratsiyi-za-10-misyatsiv-2017-roku/. 
  19. ↑ Røttingen, John-Arne; Regmi, Sadie; Eide, Mari; Young, Alison J; Viergever, Roderik F (October 2013). "Mapping of available health research and development data: what's there, what's missing, and what role is there for a global observatory?". The Lancet 382 (9900): 1286–1307. doi:10.1016/S0140-6736(13)61046-6. PMID 23697824. 
  20. ↑ Samarasekera, Udani; Horton, Richard (November 2017). "Improving evidence for health in humanitarian crises". The Lancet 390 (10109): 2223–2224. doi:10.1016/S0140-6736(17)31353-3. PMID 28602559. 
  21. ↑ 21.0 21.1 21.2 21.3 "Northeast Nigeria Health Sector Response Strategy-2017/18". WHO. April 11, 2017. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/11052017_nga_health_sector_strategy_2017_2018.pdf. 
  22. ↑ 22.0 22.1 Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh (2017). "Extending humanitarian assistance to people in the borno state of Nigeria". International Journal of Health System and Disaster Management 5 (2): 49–50. August 2017. doi:10.4103/ijhsdm.ijhsdm_33_16. http://www.ijhsdm.org/article.asp?issn=2347-9019;year=2017;volume=5;issue=2;spage=49;epage=50;aulast=Shrivastava. Retrieved 31 January 2019. 
  23. ↑ "Northeast Nigeria Response BORNO State Health Sector Bulletin #27". WHO, Borno State Government. July 2017. https://data2.unhcr.org/fr/documents/download/58529. 
  24. ↑ 24.0 24.1 "WHO: One Third of Health Facilities in Borno State Have Been Destroyed". Thisday Newspaper. January 5, 2017. https://www.thisdaylive.com/index.php/2017/01/05/who-one-third-of-health-facilities-in-borno-state-have-been-destroyed/. 
  25. ↑ "North East Nigeria - Adamawa Health Resources Availability Mapping System -HeRAMS 5W E-Atlas as of June 2018". OCHA. July 23, 2018. https://data.humdata.org/dataset/north-east-nigeria-health-resources-availability-mapping-system-herams-5w-e-atlas-as-of-june-2018. 
  26. ↑ "Nigeria: Health Resources Availability and Monitoring System (HeRAMS), Adamawa State, Assessment Report (Draft) - November 2017". WHO. November 20, 2017. https://reliefweb.int/report/nigeria/nigeria-health-resources-availability-and-monitoring-system-herams-adamawa-state. 
  27. ↑ 27.0 27.1 "Northeast Nigeria Humanitarian Response Monthly Health Sector Bulletin #2". WHO, Borno State Government. February 28, 2018. https://www.who.int/health-cluster/countries/nigeria/Borno-Health-Sector-Bulletin-Issue2-2018.pdf. 
  28. ↑ "Health system in north eastern Nigeria". WHO. November 2017. https://www.who.int/hac/herams/north-eastern-Nigeria.pdf. 
  29. ↑ "NIGERIA Health in the Northeast Thematic Report". ACAPS. 24 May 2017. https://data2.unhcr.org/en/documents/download/57121. 
  30. ↑ Orkaby, Asher (25 March 2015). "Houthi Who?". Foreign Affairs. http://www.foreignaffairs.com/articles/143295/asher-orkaby/houthi-who. 
  31. ↑ "Service Availability and Health Facilities Functionality in 16 Governorates". Yemen Ministry of Public Health & Populatione, World Health Organization Yemen Country Office. October 2016. http://www.moh.gov.ye/arabic/docs/Reports/HeRAMS%2016%20Govn%20final%20report.pdf. Retrieved 27 January 2019. 
  32. ↑ "HeRAMS-Yemen-November-2016". The Globalist. December 14, 2018. https://www.theglobalist.com/yemen-war-saudi-arabia-iran-us-arms/herams-yemen-november-2016/. 
  33. ↑ "Iraq: Health Resources & Services Availability Mapping System (HeRAMS) in Ninewa (March, 2018)". WHO. 19 Sep 2018. https://reliefweb.int/report/iraq/iraq-health-resources-services-availability-mapping-system-herams-ninewa-march-2018. 
  34. ↑ "IRQ: Ninewa HERAMS (March 2018)". OCHA. March 2018. https://www.humanitarianresponse.info/en/operations/iraq/infographic/irq-ninewa-herams-march-2018. 
  35. ↑ "Наказ Мінсоцполітики від 12 квітня 2018 року № 336 "Про затвердження структури апарату Міністерства соціальної політики України"" (in uk). Ministry of Social Policy. 12 April 2018. https://www.msp.gov.ua/content/struktura-centralnogo-aparatu-ministerstva.html. 
  36. ↑ "Declaration of the division of coordination and providing medical care during anti-terrorist operations, emergency and martial law specialist". National Agency for Prevention of Corruption. 31 March 2018. https://declarations.com.ua/en/declaration/nacp_9c1e84a6-3967-487e-a9ff-f54340e2262a. 
  37. ↑ "Реінтеграція Донбасу: що зроблено у 2017 році". The National News Agency of Ukraine. December 21, 2017. https://www.youtube.com/watch?v=xYBMTywZkg8&t=. 

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