Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps

A retrospective study

Paul Spiegel, Mani Sheik, Carol Gotway-Crawford, Peter Salama

Research output: Contribution to journalArticle

Abstract

Background: An estimated 35 million people have been displaced by complex humanitarian emergencies. International humanitarian organisations define policies and provide basic health and nutrition programmes to displaced people in postemergency phase camps. However, many policies and programmes are not based on supporting data. We aimed to identify associations between age-specific mortality and health indicators in displaced people in postemergency phase camps and to define the programme and policy implications of these data. Methods: In 1998-2000, we obtained and analysed retrospective mortality data for the previous 3 months in 51 postemergency phase camps in seven countries. We did multivariate regression with 18 independent variables that affect crude mortality rates (CMRs) and mortality rates in children younger than 5 years (<5 MRs) in complex emergencies. We compared these results with recommended emergency phase minimum indicators. Findings: Recently established camps had higher CMRs and <5 MRs and fewer local health workers per person than did camps that had been established earlier. Camps that were close to the border or region of conflict or had longer travel times to referral hospitals had higher CMRs than did those located further away or with shorter travel times, and camps with less water per person and high rates of diarrhoea had higher <5 MRs than did those with more water and lower rates of diarrhoea. Distance to border or area of conflict, water quantity, and the number of local health workers per person exceeded the minimum indicators recommended in the emergency phase. Interpretation: Health and nutrition policies and programmes for displaced people in postemergency phase camps should be evidence-based. Programmes in complex emergencies should focus on indicators proven to be associated with mortality. Minimum indicators should be developed for programmes targeting displaced people in postemergency phase camps.

Original languageEnglish (US)
Pages (from-to)1927-1934
Number of pages8
JournalThe Lancet
Volume360
Issue number9349
DOIs
StatePublished - Dec 14 2002
Externally publishedYes

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Health Policy
Retrospective Studies
Mortality
Emergencies
Health
Water
Diarrhea
Nutrition Policy
Referral and Consultation
Organizations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps : A retrospective study. / Spiegel, Paul; Sheik, Mani; Gotway-Crawford, Carol; Salama, Peter.

In: The Lancet, Vol. 360, No. 9349, 14.12.2002, p. 1927-1934.

Research output: Contribution to journalArticle

Spiegel, Paul ; Sheik, Mani ; Gotway-Crawford, Carol ; Salama, Peter. / Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps : A retrospective study. In: The Lancet. 2002 ; Vol. 360, No. 9349. pp. 1927-1934.
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