Spiegel Paul B
United Nations High Commissioner for Refugees, Public Health and HIV Section, Division of Operational Support, PO Box 2500, CH 1211, Genève 2 Dépôt, Switzerland.
Emerg Themes Epidemiol. 2007 Jun 1;4:12. doi: 10.1186/1742-7622-4-12.
Timely and accurate data are necessary to prioritise and effectively respond to humanitarian emergencies. 30-by-30 cluster surveys are commonly used in humanitarian emergencies because of their purported simplicity and reasonable validity and precision. Agencies have increasingly used 30-by-30 cluster surveys to undertake measurements beyond immunisation coverage and nutritional status. Methodological errors in cluster surveys have likely occurred for decades in humanitarian emergencies, often with unknown or unevaluated consequences.
Most surveys in humanitarian emergencies are done by non-governmental organisations (NGOs). Some undertake good quality surveys while others have an already overburdened staff with limited epidemiological skills. Manuals explaining cluster survey methodology are available and in use. However, it is debatable as to whether using standardised, 'cookbook' survey methodologies are appropriate. Coordination of surveys is often lacking. If a coordinating body is established, as recommended, it is questionable whether it should have sole authority to release surveys due to insufficient independence. Donors should provide sufficient funding for personnel, training, and survey implementation, and not solely for direct programme implementation.
A dedicated corps of trained epidemiologists needs to be identified and made available to undertake surveys in humanitarian emergencies. NGOs in the field may need to form an alliance with certain specialised agencies or pool technically capable personnel. If NGOs continue to do surveys by themselves, a simple training manual with sample survey questionnaires, methodology, standardised files for data entry and analysis, and manual for interpretation should be developed and modified locally for each situation. At the beginning of an emergency, a central coordinating body should be established that has sufficient authority to set survey standards, coordinate when and where surveys should be undertaken and act as a survey repository. Technical expertise is expensive and donors must pay for it. As donors increasingly demand evidence-based programming, they have an obligation to ensure that sufficient funds are provided so organisations have adequate technical staff.
及时、准确的数据对于确定人道主义紧急情况的优先次序并做出有效应对至关重要。30×30群组调查因其据称的简单性、合理的有效性和精确性,在人道主义紧急情况中被广泛使用。各机构越来越多地使用30×30群组调查来进行免疫接种覆盖率和营养状况以外的测量。在人道主义紧急情况中,群组调查的方法学错误可能已经存在了几十年,其后果往往未知或未得到评估。
人道主义紧急情况中的大多数调查由非政府组织(NGO)进行。一些组织开展高质量的调查,而另一些组织的工作人员已经不堪重负,流行病学技能有限。解释群组调查方法的手册已有且在使用。然而,使用标准化的“ cookbook”调查方法是否合适仍存在争议。调查协调往往不足。如果按照建议设立一个协调机构,由于缺乏足够的独立性,它是否应拥有发布调查结果的唯一权力值得怀疑。捐助者应为人事、培训和调查实施提供足够的资金,而不仅仅是直接项目实施的资金。
需要确定并提供一支训练有素的专业流行病学家队伍,以在人道主义紧急情况中进行调查。实地的非政府组织可能需要与某些专门机构结成联盟,或集中技术能力强的人员。如果非政府组织继续自行开展调查,应编写一份简单的培训手册,其中包括抽样调查问卷、方法、数据录入和分析的标准化文件以及解释手册,并根据当地每种情况进行修改。在紧急情况开始时,应设立一个中央协调机构,该机构有足够的权力设定调查标准、协调调查的时间和地点,并充当调查结果的储存库。技术专长成本高昂,捐助者必须为此买单。随着捐助者越来越多地要求基于证据的规划,他们有义务确保提供足够的资金,以便各组织拥有足够的技术人员。