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Core Commitments

for Children

are the core UNICEF policy and framework for humanitarian action

PUBLIC HEALTH EMERGENCIES (PHE)

Strategic Result

Children and their communities are protected from exposure to and the impacts of PHEs

Commitment

Benchmarks

  • Interagency and intersectoral coordination mechanisms, including cross-border, are in place and allocate clear roles and responsibilities across sectors, without gaps nor duplications

  • UNICEF led sectors are adequately staffed and skilled at national and sub-national levels

  • UNICEF core leadership and coordination accountabilities are delivered[97]

  • Surge deployments and emergency procedures are activated on a no-regrets basis

  • In case of the activation of the the IASC Protocol for the Control of Infectious Disease Events, response modalities and capacities are adapted and scaled up accordingly

1: Coordination and leadership

 

Effective coordination is established with governments and partners

 

See 2.1.2 Coordination

  • Communities are reached with gender- and age-sensitive, socially, culturally, linguistically appropriate and accessible messages on disease prevention, and on promotion of continued and appropriate use of health services

  • Local actors are supported and empowered to raise awareness and promote healthy practices

  • Systems are in place to allow communities to guide the response and provide feedback for corrective action

2: Risk Communication and Community Engagement (RCCE)[98]

 

Communities are reached with targeted messages on prevention and services and are engaged to adopt behaviors and practices to reduce disease transmission and its impact. They participate in the design, implementation and monitoring of the response for ongoing corrective action

 

See 2.2.7 Community engagement for behaviour and social change and 2.1.6 AAP

  • The risk of geographical spread of the outbreak and its potential impact are monitored, to inform early response and preparedness in at-risk areas

  • Specific needs and vulnerabilities of children and women are considered in prevention and treatment protocols, including in the design of patient-centred treatment programmes

  • Communities directly affected by the PHE are reached with Infection and prevention control (IPC)[99] activities, including the provision of critical medical, WASH supplies and services at facility, community and households’ levels and in public spaces

  • Psycho-social support services contributing to reducing transmission and PHE-related morbidity are accessible to individuals and their families directly or indirectly affected by the PHE   

  • Children directly affected by the PHE receive an integrated package of medical, nutritional and psycho-social care

  • Frontline workers at facility and community level are trained in IPC and provided with Personal Protective Equipment (PPE)[100] as appropriate for each situation and role

3: Strengthened public health response: prevention, care and treatment for at-risk and affected populations

 

Populations in at-risk and affected areas safely and equitably access prevention, care and treatment, to reduce disease transmission and prevent further spread. Specific attention is given to women and children

  • Needs assessments are conducted early and regularly to ascertain the impact of the outbreak on the population, humanitarian needs, and underlying needs not yet addressed

  • Essential services and humanitarian assistance in Health, WASH, Nutrition, HIV, are maintained and scaled-up as necessary, and communities can access them in a safe and equitable manner

  • Protection services, including case management and psychosocial support services are accessible to individuals and their families in a safe and equitable manner

  • Continued and safe access to education is maintained

  • Existing social protection mechanisms are maintained and expanded as necessary, including through establishing or scaling up humanitarian cash transfer

4: Continuity of essential services[101] and humanitarian assistance

 

Essential services and humanitarian assistance are maintained and scaled-up as necessary, and communities can safely and equitably access them

Key Considerations

Advocacy

  • Advocate for the systematic collection and reporting of standardized clinical data disaggregated by age groups and sex, as well as pregnancy status, as appropriate.

  • Advocate for the inclusion of the specific rights, needs and vulnerabilities of children, women and other vulnerable groups, such as persons with disabilities, in prevention, early detection, care and treatment strategies and programmes.

  • Advocate for timely and impartial assessment of the broader humanitarian consequences of PHEs[102].

  • Advocate for and lead an effort to improve the humanitarian response and access to safe and equitable essential services for affected communities who have been impacted by humanitarian crises since before the PHE. Advocacy should encompass pre-existing humanitarian challenges[103] and their consequences.

Coordination and Partnerships 

  • In collaboration with the government, WHO and partners, UNICEF contributes to the leadership and coordination of several outbreak response pillars, including risk communication and community engagement, immunization, psychosocial support and WASH, as well as continuation of essential health services, including education and child protection.  Which response pillars[104] are activated depends on the type of PHE and country-specific arrangements, operational capacity and other contextual factors.

  • In case of the activation of the IASC Protocol for the Control of Infectious Disease Events, UNICEF mobilizes capacities and resources to contribute to the collective response as per its mandated areas and Cluster Lead Agency responsibilities. This includes the deployment of supplies and logistics, surge capacity and the support to national and sub-national coordination.

Quality Programming and Standards

  • Continuously monitor the evolution of humanitarian needs to ensure appropriate, impartial and early response to primary and secondary impacts for the population.

  • The specific needs of children, women and other vulnerable groups must be considered in the design of the response.  Child-specific guidance and child-friendly supplies need to be prioritised for prevention, care and treatment.  Medical, nursing, nutritional, rehabilitation, mental health and psychosocial support services, as well as ECD services, need to be ensured.

  • Foster integrated and multisectoral response to stop further spread and limit negative impact on individuals and communities, involving health, nutritional and paediatric care, WASH, MHPSS, education, social science research, child protection and community engagement for behaviour and social change.  Prevention pillars may include the combination of IPC at facility, community, household level and in public spaces; risk communication and community engagement for promotion of hygiene and healthy practices; health system strengthening for detection and referral of cases and contacts; immunization; environmental health interventions and other activities, depending on the type of PHE. Case Management pillar may include the combination of provision of specialized paediatric, health and nutritional care; provision of material and psychosocial assistance to affected families; adequate referral and isolation of patients and contacts and other activities, depending on the type of PHE.

  • Strengthen and support the continuity of social services in order to minimize and reverse the negative effects of the PHE on the population, such as the reduction of routine vaccinations or discontinuity of health, education, nutrition or other social services due to reallocation of human and financial resources for the response to the PHE itself.

  • Support health system capacities to maintain routine immunization, maternal, newborn, young child and adolescent care, HIV treatment, nutrition services and capacities to respond to other life-threatening diseases

  • Pay specific attention to urban areas, which pose specific public health challenges for children, as population density facilitates the rapid spread of communicable diseases.

  • Systematically engage with communities to implement preparedness, preventive and response activities at community level.  Activities may include community surveillance; risk communication; detection and referral systems; development of isolation capacity; vector control; continuity of health and social services; and others, depending on the type of PHE.

  • GBV risks must be mitigated, and all personnel must be equipped and trained with up-to-date information on available GBV response services and referral procedures to support GBV survivors. If there are no GBV actors available, train staff on the GBV Pocket Guide.

  • Ensure that the views of affected populations are systematically used to review, inform and adapt all pillars of the public health and humanitarian response, using trusted feedback mechanisms.

  • Ensure that communities participate in decisions that affect their lives and have access to safe and confidential complaints mechanisms

Linking Humanitarian and Development

  • Promote national emergency preparedness capacities in accordance with International Health Regulations core capacities and its monitoring and evaluation framework.

  • The International Health Regulations monitoring and evaluation framework for PHE should include a child-centred perspective that guides preparedness and response, including real-time evaluations and after-action reviews.

  • Include transfer of competence, capacity-building and strengthening of national and local health, water and sanitation systems, social protection system as a core component of the prevention and response.  

  • Participate in post-outbreak after-action reviews, joint external evaluations, simulation exercises and national action plans for health security.

  • In contexts affected by conflict, fragility or major challenges to social cohesion, ensure that responses to PHEs are conflict-sensitive and do not exacerbate underlying conflict dynamics.

Footnotes

[96] PHEs also include chemical, biological, radiological and nuclear events. Not all PHEs are humanitarian emergencies.

[97] See section 2.1.2 above, overarching commitment on coordination.

[98] Risk Communication and Community Engagement (RCCE) captures the range of communication, behaviour change, social and community

mobilization strategies used in containing health outbreaks.

[99] Infection and prevention control (IPC) is a scientific approach and practical solution designed to prevent harm caused by infection to patients

and health workers. It is grounded in infectious diseases, epidemiology, social science and health system strengthening.

[100] Personal Protective Equipment (PPE) Personal Protective Equipment (PPE) consists of specialized clothing or equipment worn by health

and other workers for protection against infectious hazards.

[101] Continuity of essential services includes continued provision of primary health care (including MNCAH, immunizations, SRH, HIV/AIDS, GBV

response care, nutrition, continued access to safe water and sanitation, continued provision of child protection services, mental health and

psychosocial support (MHPSS), continuity of learning through maintained access to education, and continuity of social protection systems, and

other services depending on the situation.

[102] In line with the IASC Protocol for the Control of Infectious Disease Events, 2019.

[103] These challenges may include disease outbreaks (e.g. malaria, measles, cholera), forced displacements, natural disasters, collapsed health

and other services due to conflict etc.

[104] In Public Health Emergency (PHE), response pillars typically include: Surveillance, Contact tracing, Immunization, Infection Prevention and

Control (IPC), Risk Communication and Community Engagement (RCCE), case management, etc.

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