Attendance / hospitalisation rates
These maps can be used to show the demand placed on a health system and can be expressed as a number of measures for example: count of attendances or count of admissions / discharges to primary, secondary or tertiary care facilities. In secondary care a common measure used is the hospital discharge rate.
Strategic or operational?
Both
Basemap, baseline or situational?
Baseline and Situational
When might it be produced?
Attendances / hospitalisation rate maps are used to visualise the demand that is being placed on a healthcare system. These maps should be created as soon as the information is available, continually updated through an emergency as well as historically. It is important to look at these maps over time,including historically to demonstrate baseline demand as well as increases in demand due to a disaster / emergency.
Intended audience
Invariably health is linked to many other vulnerabilities and is impacted by all eleven clusters in the UN system (sectors of the humanitarian system that help to coordinate a humanitarian response), in particular:
Nutrition
Water, Sanitation and Hygiene (WASH)
Logistics - transport / access
The intended audience includes a variety of actors either directly involved in health, or those supporting health needs:
Ministry of Health / Department for Health
National Health Care Providers
Local Government
Civil Society / Community Organisations
Affected communities / population
National and International health related NGOs
National Red Cross / International Federation of Red Cross
World Health Organisation
Emergency Medical Teams /Emergency Medical Teams Coordination Cell
Influence on humanitarian decisions
Will be dependent on if the maps are strategic, operational or both and will vary by intended audience. To be updated based on planned expert interviews.
Methods
Access to timely and accurate data is essential for a health response. It is important to get the best available data although it may not always be perfect. Questions should be asked such as:
When was the data collected? What time period does it cover? When will it next be updated? How accurate is the data? Are the figures actual or estimates? Is it a crude number, a crude rate, an adjusted or standardised rate?
Robust information management and governance is essential when accessing, storing and visualising health data. The agreed use of the data must be established and recorded from the outset.
A process of data manipulation may be required to ensure individuals, families or villages can not be identified. A number of methods can be used to achieve this including the suppression of small numbers, aggregation of data to a higher level and minimising the use of other data / detail on a map that could make identification easier. These checks must be in place to ensure patient’s right to privacy and dignity are maintained.
Data
Count of attendances
Count of admissions
Hospital discharge rate = volume of discharges / population (excluding same day discharges including
deaths) per 100,000 inhabitants
Resources
Global Health Cluster
World Health Organisation
Emergency Medical Teams
Health Resource Availability Monitoring System (HeRAMS)
Early Warning, Alert and Response System (EWARS)
The Sphere Handbook - Minimum standards in Health action
Multi-Cluster / Sector Initial Rapid Needs Assessment (MIRA)
The International Federation of Red Cross and Red Crescent Societies
Ministry of Health / Department of Health (country specific)
ACAPS
