Introduction To Hnts (english)

HEALTH AND NUTRITION TRACKING SERVICE (HNTS) Global Health Cluster meeting, Geneva 09th June 2009 Pierre Salignon, HNTS Interim Project Director

WHAT IS HNTS ? An interagency initiative hosted by WHO, created in late 2007 by the Inter-Agency Standing Committee Health and Nutrition Clusters in response to a request made by the United Nations Emergency Relief Coordinator as part of the Humanitarian Reform process

GOALS (1) Contribute to the improvement of humanitarian operations and promote mutual accountability of the humanitarian community and beneficiaries; (2) Detect and prevent, if possible, excess mortality and malnutrition in crises; (3) Ensure that information relevant to humanitarian policy and evidence-based reports on health and nutrition needs in humanitarian crises situations are available at high-level decision-making forums.

INTENDED BENEFITS Direct support to field relief organizations Information for action Timely assessment of needs and relief response (impact - effects) Greater transparency and accountability Sharing of information (coordination) Better readability (trends) Better quality (best practices and quality of data collection / surveys - training) Field presence and capacity, tools development / standardisation if possible

MAIN FUNCTIONS Operational support to humanitarian teams in the field by: l

Peer-reviewing guidelines and other documents, participating in assessment missions, advising on the design of surveys, and providing technical advice to various agencies, NGOs.

A normative function including: l

Development of standards for data collection and measurement, collect, analysis and dissemination of data, provision of independent technical advice (i.e. method developmentvalidation of studies), training.

WHO WE ARE ? A Geneva based Technical Secretariat with 1 Project Director, 2 health and nutrition Epidemiologists, 1 administrative assistant [email protected] With field technical presence(s) in countries targeted for HNTS implementation l

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Democratic Republic of Congo / first HNTS field epidemiologist through a NGO partnership Others in the future ?

The Steering Committee (SC) The Expert Reference Group (ERG) l

A roster of experts for field deployment in the future ?

COUNTRIES TARGETED 2008 l

Uganda, Myanmar, DRC…

2009 – 2011 l l

Democratic Republic of Congo Others ? Asia, Africa, Central Asia… ? • CAR/Chad/Sudan (see review of surveys)

In the future, reactivity to new crises l

Depending requests and mobilization of partners, ERC and Health-Nutrition Clusters, NGO community

TECHNICAL CONSULTANCIES Priority indicators in complex emergencies l

HNTS indicators, support to SPHERE revision and other data collection initiatives

Mortality estimates in crisis affected populations – inference from multiple sources l

Quality scoring of surveys

Review of surveys for 2006 – 2008 in North Kivu l

See recommendations about systematic peer review of surveys, training… etc.

Peer review of IRC surveys in DRC 1996 – 2008 l

See report and comments

Review of surveys for 2004 – 2009 in Darfur (July)

MORTALITY AND NUTRITION PRIORITIES Survey methodologies and validation of surveys Surveillance Determination of needs for nutrition programming Real-time monitoring of the food and nutrition situation in vulnerable communities Relative interest of different methods for assessing nutrition and mortality situations and triangulation of information

SUPPORT TO EXISTING DATA COLLECTION INITIATIVES SPHERE l

2010 Revision process (nutrition and health)

Global Health Cluster (GHC) l

Definition of health indicators

OCHA l

Humanitarian dashboard effort and the overall ACE project + Needs Assessment Group (NAG)

IPC / FAO - WFP l

Review of health / mortality - nutrition indicators

WHO l

Technical support to tools development (IRA, Herams, others)

Field technical support l

Development of the HINTS early warning automatic analysis tool

WHAT WE NEED ? Mobilization of GHC and GNC partners l

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Use of Health and Nutrition Tracking Service at HQ and field levels (see operational and normative functions) DRC / North Kivu – development of direct HNTS technical field support to relief organizations and national authorities… Review of surveys in Darfur Sudan 2003 – 2009, access to surveys… Identification of new countries targeted for HNTS implementation ?

Mobilization of donors community and UN agencies l

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Ensure financial stability of HNTS project in the 2 coming years (credibility – trust with all partners) Ensure stability of competencies and HR Develop reactivity to new emergencies / crises ?

HNTS / GHC cooperation Expectations from HNTS l

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Active participation of GHC members to the HNTS Steering Committee Exchange of information available about countries targeted for HNTS implementation – access to surveys and data… • DRC • Others ? New crises / emergencies

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Support HNTS project's development and products' visibility Possible request to HNTS to support Clusters partners data collection efforts in crises, and also in new emergencies, through the health and nutrition clusters Development of the peer review function of HNTS Possible HNTS technical support/participation to new coordinated multi-sectoral assessments Ensure GHC members political and financial support to HNTS project…

Questions to GHC members l

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What are the expectations of the GHC about HNTS ? Are there specific requests from the GHC to HNTS ? How can the GHC members ensure political and financial support to HNTS project for the coming two years ? Are the GHC members ready to support the development of HNTS field technical activities in countries targeted for HNTS implementation ? How ? • Let's start in DRC – North Kivu ?

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How can the GHC members better use the HNTS initiative as a catalyst for the humanitarian community when trying to strengthen data collection, consolidation, analysis and interpretation… ? Are YOU still convinced about the need to develop HNTS and fill gaps in data collection, surveys… ?

Some risks and pitfalls History of HNTS, "expectations" and "frustrations"… pressure to "move forward" fast, lack of funds… Independence of HNTS ? Timing to build trust and synergy between HNTS and (field) partners; Complexity of the project because of technical aspects and no easy agreement between partners / donors; "Political factors" that could constrain the HNTS roll-out in certain cases; Suspicion of motives around data collection in crises; Tracking work that could be delayed by access problems due to insecurity; Poor coordination; failure to share data; Absence of data, unreliable and/or untimely data, difficulties in interpretation; Improvements less likely to be measured;

… "Numbers game", risk of "death inflation", inappropriate extrapolation of data, sharing data versus their political misuse, wrong focus on "dead" instead of "saving lives", etc; The commitment to humanitarian system reform remains fragile and will influence the extent to which cooperation at global and country levels is maintained to put the HNTS into practice; Financial support to HNTS must be strengthened and donors group enlarged; HNTS team turn over as well as turn over of staff in relief organizations and partners.