Disaster Risk Reduction and Health Technical Note

1. Background

1.1 Purpose

In response to UNICEF’s recognition of an increase in disaster risk, due in part to rapid urbanisation, environmental degradation and climate change, UNICEF developed a Programme Guidance Note on Disaster Risk Reduction (DRR) in March 2011. In support of this, a series of five Technical Notes, one for each of UNICEF’s five main programme sectors (Health, Nutrition, Education, WASH and Child Protection), has been developed. These are intended to help practitioners identify how sector work can contribute to reducing disaster risk.

1.2 Disaster Risk and Disaster Risk Reduction (DRR)

Disaster risk is the potential loss expressed in lives, health status, livelihoods, assets and services, which could occur in a particular community or a society due to the impact of a natural hazard. 1 In other words, disaster risk is a ‘disaster waiting to happen’, as is the case for the high numbers of vulnerable people forced to live on flood plains, in drought prone areas or in unplanned urban settlements.

Disaster risk is commonly understood as a function of hazards, vulnerability, exposure and capacities, which can be described in the following formula:

Risk = Hazard x Vulnerability x Exposure Capacity

Disaster risk reduction (DRR) is a systematic approach to identifying, assessing and reducing that risk. Specifically, the purpose of disaster risk reduction is to minimise vulnerabilities and disaster risks throughout a society in order to avoid (prevent) or to limit (mitigate and prepare for) the adverse impacts of natural hazards, and facilitate sustainable development.

In 2005, a global framework for DRR was developed and endorsed by 168 UN member states. The Hyogo Framework for Action (HFA) ‘Building the Resilience of Nations and Communities to Disasters’ highlights five priorities for action for reducing disaster risk: (1) making DRR a priority, (2) identifying, assessing and monitoring risks, (3) building understanding and awareness, (4) reducing the underlying risk factors, and (5) strengthening preparedness at all levels.2

This technical note provides practical guidance to adapting UNICEF’s existing programmes to protect them from disasters, to decrease disaster risks and to build individual and community-level resilience.3

1 Adapted from ISDR (2009). 2 See www.unisdr.org/files/1217_HFAbrouchureEnglish.pdf. 3 UNICEF recognises the importance of looking at risk more broadly. To this end, UNICEF is currently advancing its understanding of resilience. Programme guidance on conflict prevention will also be available later in 2012: http://intranet.unicef.org/Emops/EMOPSSite.nsf/root/Page0603.

1 1.3 UNICEF and DRR

Child-centred DRR and the Children’s Charter for DRR Child-centred DRR requires focusing on the specific risks faced by children, as well as involving children in initiatives to reduce disaster risk. In 2011, UNICEF, Plan International, Save the Children and World Vision developed a Children’s Charter for DRR (see section 2.4 for link to Charter), through consultations with 600 children, which outlines five key priorities identified by children. UNICEF is working at the country, regional and global level to raise awareness of this Charter and to support progress in terms of the implementation of its five priorities.

Disasters negatively impact children’s and women’s rights, disproportionately affect poor countries and poor communities, erode development gains and set back progress in achieving the Millennium Development Goals (MDGs). Increased school drop-out, high incidence of disease and mortality, and a worsening of the nutrition status in the affected population are all likely results of a disaster. Disaster risk is therefore not only the highest among the most vulnerable but exacerbates existing vulnerabilities and inequalities of girls, boys, women and men.

While poor development or under-development are key drivers of disaster risk, humanitarian action too can influence disaster risk. UNICEF therefore considers disasters as both a development and a humanitarian concern. UNICEF has incorporated DRR in its Core Commitments for Children in Humanitarian Action (CCC) and is taking steps to incorporate DRR throughout its programme sectors.Criteria To and facilitate principles this, forUNICEF UNICEF’s is increasingly DRR work including a multi-hazard risk assessment in the country office Situation Analyses.4 Criteria of ‘good practice’ in DRR: With its local, sub-national and national presence before, during and after disasters, UNICEF is well placed1. to supportThe action the capacityaims explicitly development at reducing of governments/partners. disaster risk, by addressing This not only vulnerabilities helps ensure andsocial services arecapacities ‘risk informed’ in the contextbut can ofbetter natural link communityhazards. DRR projects with national, provincial and district level policies and plans. 2. The action should be informed by a disaster risk assessment, which considers specific Whilst theserisks Technical to children, Notes multiple-hazards focus on what each and programme climate change. sector can contribute towards reducing disaster risk, it is important to recognise that effective risk reduction requires multi-sectoral action. Moreover,Principles DRR of ‘good also practice’requires inlinking DRR: effectively with policies and programmes in social protection, conflict prevention and other risk management approaches that contribute to resilience. 1. The action targets the population groups most at risk, as identified through the disaster UNICEF hasrisk developed assessment four and goals analysis. for its DRR work (adapted from the Hyogo Framework for Action priorities) to ensure efforts to reduce disaster risk focus specifically on children: 2. The action is multi-sectoral, as effective DRR requires different sectors to work together to reduce risk to women and children. UNICEF’s DRR goals: 1. DRR for children and women is a national and local priority 3. The action addresses the immediate and underlying causes of disaster risk, and 2. Different risks faced by girls, boys, adolescents and women are identified and addressed contributes to bridging the gap between humanitarian action and development planning. 3. Safer and more resilient conditions for girls, boys and women 4.4.StrengthenedThe action humanitarianis child-centred preparedness,, focusing on response the vulnerabilities and recovery and through capacities capacity of children. development

5. The action is participatory, based on local knowledge of risks and input from communities.

4 Work 6.is underwayThe actionin Nepal, isPakistan coordinated and India to develop with humanitariannational-level child-centred and development risk assessments; partnersand globally, to as strengthen riskcoordination assessment guidance and collaboration in the programme is essential cycle and for at the effective sub-national DRR. level. 2 7. The action focuses on capacity development of communities, governments and institutions, to ensure sustainability and scale up of DRR interventions. 2. Health and DRR

3 2.1 Introduction

All disasters are a health issue, impacting on the health of the population and bringing about substantial losses and disruption to health systems.5 In low income countries, where national health budgets and systems are already unable to meet basic public health needs, and in fragile and post- conflict/disaster contexts, even relatively minor shocks can overwhelm the coping capacity of the health system. Disasters exacerbate the most common causes of childhood mortality, including diarrhoea, pneumonia, malaria, malnutrition and neonatal causes. As 30 – 50 per cent of fatalities arising from disasters are children, reducing disaster risk is a key issue for UNICEF.

UNICEF takes a multi-hazard approach to DRR for the health sector. This includes managing the risks to hazards such as natural (weather related and geophysical), societal (conflict, mass gatherings), biological (pandemics, epidemics, pest related) and technologic, some of which are likely to increase due to climate change such as weather related disasters (floods, droughts and cyclones) and epidemic- prone diseases. However, the actions in section 2.2 below will focus on reducing disaster risks from natural and biological hazards, and preparing health systems and communities for emergency response to all hazards. The approach will be based on a risk analysis which will also take into account additional vulnerabilities due to rapid and unplanned urbanisation and those attributed to climate change such as changing disease patterns, malnutrition and migration and conflict due to limited resources.

Note on climate change and adaptation: Climate change can affect health through direct causes due to changing disease patterns and reduced food security but can also have secondary consequences with disruption of health and other essential services from climate related disasters and population movements often to urban areas to search for resources. Climate sensitive diseases include vector-borne (malaria and dengue), diarrheal and respiratory diseases and malnutrition. Climate change adaptation helps people cope with impacts that cannot be avoided or mitigated through building resilience of communities and essential services.

Risk is defined as an interaction of hazards with the vulnerabilities and the capacities of communities and health and other critical services. The amount of risk (morbidity and mortality) will be related to the vulnerabilities of the community and the health system (proximity to hazards including peri-urban areas, underlying health status, and access to essential public health services) and the capacity of the community and health and other essential services to respond to the on-going and emergency health needs of the community. Effective, flexible and adaptable health systems provide essential protection from disaster-related risks and support communities to respond to and recover from disasters. The presence of UNICEF close to hazard-prone communities, through strong partnerships in the field, allows it to be a key part of a comprehensive strategy at all levels, using all the existing health force including community-based health workers.6

5 Merlin, Health and Disaster Risk Reduction, February 2009. 6Scaling up the community-based health workforce for emergencies: http://www.unicef.org/media/files/Scaling- up_community-based_health.pdf.

4 In line with UNICEF’s four DRR goals, the health sector aims to reduce the risk of illness and death from (risk here is defined as morbidity and mortality, often noted as a crude or under 5 mortality rate above a certain threshold) from disasters by: 1. Preventing (avoid) hazards: a. Biological hazards: pandemics and epidemics b. Working with other sectors to reduce the impacts of natural hazards 2. Reducing vulnerability and increasing capacity of the community and health systems (limit: mitigate or prepare for) a. Increasing access to critical health services, particularly community based through flexible and adaptable health systems and programmes b. Protecting health services during an emergency c. Preparing families, communities and health services for emergencies

The first step in terms of reducing disaster risk is to ensure that health is part of any multi-hazard risk assessments that take place informing the country situation analysis or at any stage during the UNICEF Country Programme cycle and Early Warning Early Action (EWEA) system.

2.2 Guidance for Interventions

The table below provides some key DRR/CCA interventions that can be made through the health sector. This is not intended to be a comprehensive guide to all health and DRR activities. Instead its aim is to provide some key actions that the health sector can undertake to reduce disaster risk. Please see annex 1 for a more detailed table of DRR and health actions, broken down by the five priorities of the Hyogo Framework for Action.7

7 For further information on health and the Hyogo Frame for Action, please refer to the WHO fact sheet on Disaster Risk Management and Health: http://www.who.int/hac/events/drm_fact_sheet_overview.pdf

5 Type of activity DRR and Health actions

Prevention8/Mitigation9  Include risks to health and health systems (in particular to children) in national and local risk assessments  Work with WHO and partners to determine and integrate biologic hazards (epidemic and pandemic-prone diseases) into the national hazard assessment  Based on risk assessments, target health programmes towards most vulnerable communities in order to improve baseline health status  Make health facilities safe from disasters through retrofitting and locate health facilities and services away from hazard-prone areas  Increase access to priority health services to address the top causes of morbidity and mortality of children by targeting most at risk areas and strengthening community-based interventions through flexible and adaptable health systems and programmes  Prevent the risk from biological hazards through the detection, prevention and control of diseases of epidemic and pandemic potential Preparedness10  Link UNICEF’s health programs to existing (national, sub-national and community) early warning systems  Ensure community based surveillance systems are in place  Provide information to UNICEF supported health program partners on early warning systems and how to act on them  Prepare UNICEF specific health programs for possible hazards, including preparedness and response plans, pre-positioning of supplies, training of staff and identification of surge capacity  Provide risk awareness and health education to communities on local hazards and emergency preparedness and response measures for communities and families Response11/Early  Provide adequate resources and supplies to continue with priority health services to target the top causes of illness and death in Recovery12 the most vulnerable locations while re-establishing health systems

8 Prevention: The outright avoidance of adverse impacts of hazards and related disasters. Very often the complete avoidance of losses is not feasible and the task transforms to that of mitigation. Partly for this reason, the terms prevention and mitigation are sometimes used interchangeably in casual use (source: http://www.unisdr.org/we/inform/terminology) 9 Mitigation: The lessening or limitation of the adverse impacts of hazards and related disasters (source: http://www.unisdr.org/we/inform/terminology) 10 Preparedness: The knowledge and capacities developed by governments, professional response and recovery organizations, communities and individuals to effectively anticipate, respond to, and recover from, the impacts of likely, imminent or current hazard events or conditions (source: http://www.unisdr.org/we/inform/terminology) 11 Response: The provision of emergency services and public assistance during or immediately after a disaster in order to save lives, reduce health impacts, ensure public safety and meet the basic subsistence needs of the people affected. Disaster response is predominantly focused on immediate and short-term needs and is sometimes called “disaster relief”. The division between this response stage and the subsequent recovery stage is not clear-cut. Some response actions, such as the supply of temporary housing and water supplies, may extend well into the recovery stage (source: http://www.unisdr.org/we/inform/terminology) 12 Recovery: The restoration, and improvement where appropriate, of facilities, livelihoods and living conditions of disaster-affected communities, including efforts to reduce disaster risk factors. The recovery task of rehabilitation and reconstruction begins soon after the emergency phase has ended, and should be based on pre-existing strategies and policies that facilitate clear institutional responsibilities for recovery action and enable public participation. Recovery programmes, coupled with the heightened public awareness and engagement after a disaster, afford a

6  Carry out analysis of the reasons why health facilities and services have been damaged or interrupted and find suitable ways to modify existent/future systems against this damage  Rebuild or re-start health systems and services so that they are resilient to all hazards

valuable opportunity to develop and implement disaster risk reduction measures and to apply the “build back better” principle (source: http://www.unisdr.org/we/inform/terminology).

7 In Myanmar, Cyclone Nargis struck in May 2008, killing more than 140,000 people and damaging infrastructure and property worth billions of dollars, including over 600 health facilities. UNICEF’s immediate priority was to reinstate education infrastructure and health care networks. With the support of funds provided by the Government of Japan, UNICEF designed and built 24 rural and sub- rural health centres between 2008 and 2010. These were located in some of the most affected areas of south-west Myanmar, in Ayeyarwaddy division, where the existing health centres had been destroyed, and serve the primary health needs of an estimated population of 150,000. Some of the health facilities were reconstructed using lightweight technology suitable for soft (mangrove) soil conditions with low loadbearing capacity. In other places, the structures were built with reinforced concrete. However, both types of structures were built with the capacity to withstand strong winds and earthquakes. Lightning protection was also installed as this is a frequent hazard experienced in the area. UNICEF also provided 102 fibre glass boats to health workers in 12 townships affected by Cyclone Nargis to help organise outreach activities in future flood situations.

2.3 References and Resources

For further information, please contact:

Heather Papowitz, Senior Health Adviser, UNICEF New York: [email protected] Antony Spalton, DRR Specialist, UNICEF Geneva: [email protected]

For further reading, please refer to:

General DRR reading

 UNICEF, Programme Guidance Note on DRR: http://intranet.unicef.org/emops/emopssite.nsf/root/Page050206

 UNICEF DRR brochure: http://intranet.unicef.org/CoP/EMOPSDRR/Blog.nsf/dx/DRR_final.pdf/$file/DRR_final.pdf

 UNICEF’s Community of Practice on DRR: http://intranet.unicef.org/CoP/EMOPSDRR/CommunityContent.nsf

 Children’s Charter for DRR: http://www.childreninachangingclimate.org/database/CCC/Publications/children_charter.pdf

 Hyogo Framework for Action, 2005 – 2015 http://www.unisdr.org/files/1217_HFAbrochureEnglish.pdf

 UNDG Guidance Note on Integrating Disaster Risk Reduction into the CCA and UNDAF 2009: http://www.undg.org/docs/9866/UNDG-DRR-Guidance-Note-2009_DUP_08-07- 2009_11-43-02-734_AM.PDF

 Children in a Changing Climate, Children and Disaster Risk Reduction: Taking Stock and Moving Forward: http://www.unisdr.org/files/12085_ChildLedDRRTakingStock1.pdf

 Children in a Changing Climate, Children and Disasters: Understanding Impact and Enabling Agency:

8 http://www.childreninachangingclimate.org/database/CCC/Publications/IMPACTS%20and %20AGENCY_FINAL.pdf.

 Plan International, Child-Centred Disaster Risk Reduction – Building Resilience Through Participation: http://www.plan-uk.org/resources/documents/33987/

 Save the Children, Reducing Risks, Saving Lives – Our Approach to Disaster Risk Reduction: http://www.savethechildren.org.uk/resources/online-library/reducing-risks-saving-lives-our- approach-to-disaster-risk-reduction.

 UNICEF and Plan International, The benefits of a child-centred approach to climate change adaptation: http://www.unicef.org.uk/Documents/Publications/ClimateChange_child_centred2011.pdf.

 UNICEF, Children’s Vulnerability to Climate Change and Disaster Impacts in East Asia and the Pacific: http://www.unicef.org/media/files/Climate_Change_Regional_Report_14_Nov_final.pdf.

DRR and Health

 WHO/ISDR Thematic Platform for Disaster Risk Reduction and Health http://safehospitals.info/images/stories/5GoodPract/ResearchAndDev/thematic_platfom_risk_ reduction_health_12oct09.pdf

 Disaster Risk Reduction fact sheet: General http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1296686244041

 WHA 2011: Executive Board 128 Resolution 10 Strengthening national health emergency and disaster management capacities and resilience of health systems http://apps.who.int/gb/ebwha/pdf_files/EB128/B128_R10-en.pdf

 IASC Global health Cluster Guidance Note on the Promotion and Advocacy for Stronger National and Local Capacities in Health Emergency Preparedness and Risk Reduction http://www.humanitarianreform.org/humanitarianreform/Portals/1/cluster%20approach %20page/clusters%20pages/health%20cluster/20090907_GHC%20guidance%20on %20advocacy%20for%20prep%20and%20rr%20.pdf

 Benchmarks, Standards and Indicators for Emergency Preparedness, WHO South-East Asia Region http://www.searo.who.int/LinkFiles/EHA_Benchmarks_Standards11_July_07.pdf

 Joint Statement on scaling up the community-based health workforce for emergencies http://www.who.int/workforcealliance/media/news/2011/chwemergencystory/en/index.html

 WHO/PAHO Health Sector Assessment tool for DRR http://new.paho.org/disasters/index.php? option=com_content&task=view&id=1375&Itemid=1

 IFRC Community based health and first aid (see module 3) http://www.ifrc.org/PageFiles/53437/CBFA-volunteer-manual-en.pdf

9  Hospitals Safe From Disasters: http://www.unisdr.org/2009/campaign/pdf/wdrc-2008-2009- information-kit.pdf

 PAHO Safe Hospital checklist: http://www.paho.org/English/dd/ped/SafeHospFormsEng.pdf

 Health Facility Checklist Guidelines for the assessment of small health facilities (Spanish) http://new.paho.org/disasters/index.php? option=com_content&task=view&id=1152&Itemid=1

 Information management and communication in emergencies and disasters http://new.paho.org/disasters/index.php?option=com_content&task=view&id=997&Itemid=1

 UNICEF Behaviour Change Communications (BCC) in emergencies http://www.unicef.org/ceecis/BCC_full_pdf.pdf

International Health Regulations (IHR) and disease early warning

 International Health Regulations (IHR) http://whqlibdoc.who.int/publications/2008/9789241580410_eng.pdf

 IHR core capacity monitoring framework: Checklist and Indicators for Monitoring Progress in the Development of IHR Core Capacities in States Parties http://whqlibdoc.who.int/hq/2011/WHO_HSE_IHR_2011.6_eng.pdf

 Protocol for assessing the national surveillance and response capacities for IHR http://www.who.int/ihr/publications/who_hse_ihr_201007_en.pdf

 WHO Early warning surveillance and response in emergencies http://whqlibdoc.who.int/hq/2010/WHO_HSE_GAR_DCE_2010.4_eng.pdf and http://whqlibdoc.who.int/hq/2011/WHO_HSE_GAR_DCE_2011.2_eng.pdf

Climate Change and Adaptation and Health

 WHO Consultation on the Essential Public Health Package to Enhance Climate Change Resilience http://www.who.int/globalchange/mediacentre/events/2010/EssentialPublicHealthPackage_Se ptember_2010_Consultation_Meeting_Report.pdf

 World health assembly resolution Climate Change and Health http://www.who.int/globalchange/A61_R19_en.pdf

 PAHO Protecting Health from Climate Change Vulnerability and Adaptation Assessment 2010 http://www.who.int/globalchange/VA_Guidance_Discussion.pdf

 Protecting the health of vulnerable people from the humanitarian consequences of climate change and climate related disasters http://www.unisdr.org/files/11036_0471.pdf

 WHO Climate change adaptation (CCA) resources http://www.who.int/globalchange/resources/en/

 WHO Training course for public health professionals http://www.who.int/globalchange/training/health_professionals/en/index.html

10 11 Annex 1

DRR and Health Actions (categorised under the Hyogo Action for Framework priorities)

UNICEF’s contribution to ensure disaster risk management for health is a national and local priority (HFA priority 1)  Designate UNICEF health section focal point responsible for Disaster Risk Reduction (DRR/CCA) at all levels (national, sub-national)

 Link with existing MoH or WHO led DRR and CCA programs and operations to provide input and offer technical and operational support

 Identify roles and responsibilities of each of UNICEF health programme staff in DRR/CCA

 Review national plans (to ensure health is adequately included)

 National Disaster Management Plan

 National Adaptation Program of Action (NAPA) for climate change adaptation (examples of country plans http://unfccc.int/cooperation_support/least_developed_countries_portal/submitted_napas/items/4585.php )

 Review the national health DRM plan and see how UNICEF can support and integrate components such as

 Child health  Maternal and neonatal health  Immunisations  Supplies of essential medicines  Outbreak control

 Injuries and mental health

 Review the national International Health Regulations (IHR) strategy and National Preparedness plans for disease outbreaks (cholera, malaria)

 Integrate DRR into UNICEF health sector Country Program Document (CPD) and ensure risks to health and health systems are adequately covered in the SitAn.

12  Allocate adequate resources including staff, supplies and funding towards DRR. Propose funding and resource options to fill any gaps.

 Review national DRR policies and advocate for practical strategies to involve communities in disaster management planning for health

UNICEF’s contribution to health risk assessment and early warning, including risks posed by climate change (HFA Priority 2) Risk Assessments

 Review the National Disaster Management Authorities’ national hazard and risk assessment

 Review the national assessments of risks posed by climate change (consult with UNEP)

 Discuss with UNDP to be included in UN programme conducting national, sub-national and community risk assessments

 Discuss with UNEP to be included in UN programme to assess climate related risks on populations and essential services

 Discuss with IFRC/RC/RC (or other NGOs) if they are conducting community-based risk assessments

 Coordinate with WHO to integrate health related vulnerabilities of children into the national risk assessment including:

 Vaccination coverage including measles  Mortality and prevalence rates of common childhood illnesses including neonatal and HIV prevalence where applicable  Rates of under-nutrition  Climate-sensitive health risks affecting children (malaria, diarrhoea)

 Children in marginalized areas including peri-urban slums, close to hazard zones, and displaced.

 Coordinate with WHO input into national health sector risk assessment for the vulnerabilities and capacities of UNICEF supported health services including urban/peri-urban vulnerabilities and the degree the health system can respond and manage climate sensitive risks for:  Child health  Maternal and neonatal health  Immunisations  Supplies of essential medicines  Outbreak control  Injuries and mental health  With WHO determine and integrate biological hazards (epidemic and pandemic-prone diseases) into the national hazard assessment

13  Work with WHO and partners to involve communities at risk including children in the risk assessment process

Early Warning and Surveillance  Ensure UNICEF’s health programmes are linked to existing (national, sub-national and community) early warning systems and put mechanisms in place to ensure information is acted upon adequately  Share information with UNICEF supported health programme partners on disaster early warning and early action systems

 Work with WHO/national authorities and partners to make sure early warning systems are understandable to children and they know how to act

 Work with the WHO/national authorities to provide input and support to the national disease early warning systems for diseases of epidemic and pandemic potential, including community-based surveillance (CBS).  Link with other sectors to integrate disease early warning systems into their early warning and response systems  With WHO and UNEP integrate forecasting climate-sensitive diseases through integrated health and environment surveillance and use of climate risk information into programmes

 Establish how the UNICEF office can better support the national system to implement the International health Regulations (IHR) including early warning, support to surveillance systems through partners and outreach programmes, preparedness and response to outbreaks and risk communications

UNICEF’s contribution to education and information to build a culture of health and safety resilience at all levels (HFA priority 3)  With MoH/WHO input into the national and health sector risk awareness campaigns

 As part of the health sector risk awareness campaign, integrate risk awareness messages for child/newborn health (with other key sectors WASH, nutrition, educations and protection), vaccinations, epidemic/pandemics, injuries and mental health.

 Contribute to awareness raising and social mobilisation using information from risk assessments, climate and surveillance data to inform communities on the public health risks of climate change and community-based adaptation strategies with special emphasis on children

 Evaluate risk awareness messages so that they are understandable to children when relevant

 Through UNICEF partners, train health staff in all of UNICEF supported health programmes at all levels on disaster risks and the steps to take to reduce risks and prepare for emergencies

14 UNICEF’s contribution to reduction of underlying risk factors to health and health systems (HFA priority 4)  Based on risk assessment findings, target health programmes towards most vulnerable communities to improve baseline health status

 Prevent biological hazards through maximising vaccination coverage of measles, polio and meningitis and where appropriate cholera and work with the WASH sector to reduce the underlying causes of outbreaks

 Prevent biologic hazards through reducing the animal human transmission of zoonotic diseases and preventing water and vector borne diseases

 Make health facilities safe from disasters through retrofitting and ensure that health facilities and services are located away from hazard-prone areas

UNICEF’s contribution to health sector disaster preparedness for all hazards (HFA priority 5)  Contribute to national health sector preparedness planning with MoH and WHO:

 Formulation of emergency management plans

 Coordination and communication structures with MoH and WHO including roles and responsibilities

 Use of climate forecasts and early warning and response systems

 Preparing resources such as trained staff, supplies and funding

 Preparing national, sub-national and community programmes to prevent and control communicable diseases, provide primary health, care mass casualty management, first aid, psychosocial and mental health and health promotion and education

 Strengthen community response and capacity building of the community-based health workforce

 Prepare UNICEF specific health programmes (vaccination, child health, maternal and neonatal health, disease control programmes, and injury and mental health programmes) so that they are flexible, adaptable and able to respond to possible emergencies including preparedness and response plans, pre-positioning of supplies (including inventories of essential supplies and supply plans with PD), training of staff, identification of surge capacity, information management including pre-existing health data, coordination and communication lines and develop health education and promotion messages based on risk assessments.

 Work with MoH/WHO and other partners on disease specific including climate sensitive epidemic/pandemic preparedness plans