2015 ANNUAL GLOBAL OVERVIEW

Transcription

1 ANNUAL GLOBAL OVERVIEW REPRODUC TIVE HEALTH & HIV PUBLIC HEALTH WASH NUTRITION & FOOD SECURIT Y

2 Public Health ANNUAL GLOBAL OVER VIE W UNHCR s public health programmes are underpinned by universal addressed human rights principles. Ensuring access to health care is a key compo- programmes needed to be scaled up quickly in Tanzania, and nent of UNHCR s protection mandate and a life-saving operational DRC to address urgent health needs of fleeing Burundians, in Europe in priority. UNHCR seeks to ensure that all refugees can access quality response to the refugee and migrant crisis and in, Niger and public health, reproductive health and HIV services, while prioritizing where Nigerian refugees required life-saving assistance. UNHCR assistance to those most in need. UNHCR prioritizes cost-effective, supported the response to outbreaks of cholera (Tanzania, ) and evidence-based services integrated into the public health system. In measles ()., globally, under mortality rate was.4 per per month, with country level. Public health interventions and UNHCR s public health strategy continued to focus on synergies and 141 out of 144 (.9) reporting sites meeting standards. Measles integration into national health care systems and alternative health vaccination rates slightly improved to 9.2. However, there are still financing options including health insurance schemes. issues with the quality of HIS vaccination data that need to be DISEASE PROFILE U N D E R - F I V E M O R TA L I T Y Deaths/1,/month (lowest-highest rates) Proportion of all consultations 6,4,639 at Total number of consultations in 2 countries Communicable diseases (,918,223) Standard <1. Mental Health (117,46)..2 Non-communicable diseases (2,9) Injuries (3,) Deaths/1,/month ( S t a n d a rd < 1. ) H E A LT H U T I L I S AT I O N R AT E N e w v i s i t s / p e r s o n / ye a r ( S t a n d a rd 1-4 ) 3.3 M E A S L E S CO V E R AG E Pro p o r t i o n re c i e ve d m e a s l e s v a cc i n a t i o n ( S t a n d a rd 9 ).43 Nepal : N o t re l i a b l e d : a t a Not Available data : Not reliable 2.6 Thailand Yemen S o m e s i te s e xce e d e d t h e s t a n d a rd fo r u n d e r- fi ve m o r t a l i t y. Iraq.9 Guinea.1 U N D E R - F I V E M O R TA L I T Y.61 Jordan Mauritania Co u n t r y ove r v i e w Ghana Burundi.3 Zambia Congo (DR) Congo (Rep) Tanzania Highlights Mental Health: Fo r U N H C R m e n t a l h e a l t h a n d p s yc h o s o c i a l s u p p o r t ( M H P S S ) i s a n i n te gra l p a r t o f i t s p u b l i c h e a l t h p ro gra m m a n d a te. Ty p i c a l l y, M H P S S i n te r ve n t i o n s a re n o t we l l a d a p te d to t h e re f u g e e co n te x t. I n o rd e r to t a c k l e t h i s, U N H C R a n d W H O d e ve l o p e d t h e m h G A P H u m a n i t a r i a n I n te r ve n t i o n G u i d e to e n a b l e n o n - s p e c i a l i ze d h e a l t h c a re p rov i d e r s s u c h a s n u r s e s a n d d o c to r s to p rov i d e b a s i c c l i n i c a l m a n a g e m e n t o f m e n t a l d i s o rd e r s a n d p s yc h o s o c i a l s u p p o r t i n re f u g e e c a m p s. I n C h a d, Ca m e ro o n a n d E t h i o p i a a to t a l 2 7 s t a ff f ro m p a r t n e r o rg a n i s a t i o n s a n d g ove r n m e n t s we re t ra i n e d. S m a l l gro u p s o f 2 p a r t i c i p a n t s fo l l owe d fo u r- d ay t ra i n i n g s by e x p e r i e n ce d t ra i n e r s. E x p e r i e n ce s we re ve r y p o s i t i ve a n d t h e k n ow l e d g e a n d s e l f - re p o r te d co m p e te n ce to a s s i s t p e o p l e w i t h m e n t a l d i s o rd e r i n c re a s e d. N e x t ye a r s i m i l a r t ra i n i n g s w i l l b e o rg a n i s e d i n o t h e r co u n t r y o p e ra t i o n s

3 Reproductive Health & HIV ANNUAL GLOBAL OVER VIEW UNHCR places great importance on providing good quality reproductive while 83(6.4) had a rate > 9. health services to refugee populations. UNHCR continues to bolster In, had access to antiretroviral treatment as nationals, while reproductive health services as an important and integral part of its official access to services is equal, unfortunately not all refugees have yet public health programmes. During emergencies, prioritisation of con- access to comprehensive HIV services, however. It remains of concern text-specific adaptive models was made to ensure reproductive health that 4 countries still have mandatory testing for asylum seekers at entry services are scaled up from basic to comprehensive services and integrat- or for renewal of refugee permits. UNHCR strictly opposes mandatory HIV ed into the national system as soon as possible testing of asylum-seekers, refugees, IDPs and other persons of concern The number of women accessing safe deliveries increased to 9. Out of and continues to advocate to an end to mandatory testing. This issue was the 26 reporting countries, 13() were able to achieve a coverage of > highlighted during the thematic day on HIV in emergencies held at the 9 while (76.9) Countries had coverage rates above out of 36th UIDS Program Coordinating Board (PCB) meeting in July the 127 reporting sites (7.) had a skilled birth attendency of > 9 and it is fully integrated into the new UIDS -21 strategy. R E P R O D U C T I V E H E A LT H & H I V P R O F I L E S K I L L E D B I R T H AT T E N D A N C E Proportion of countries Proportion of all births (lowest-highest proportions) Countries meeting contraceptive prevalence rate standard ( 3) c Countries with access to ART equal to nationals a Standard Countries meeting the coverage standard of 4 ANC visits ( 9) d Countries with access to newborn care b Number of countries included in analysis a) 42, b) 42, c) 23, d) Co u nt r y ove r v i e w S K I L L E D B I R T H AT T E N DA N C E Pro p o r t i o n o f a l l b i r t h s ( St a n d a rd 1 ) Jordan P O S T - E X P O S U R E P R O P HYL AX I S Pro p o r t i o n o f e l i gi b l e ra p e s u r v i vo r s p rov i d e d w i t h P E P w i t h i n 7 2 h o u r s ( St a n d a rd 1 ) PMTC T CO V E R AG E Pro p o r t i o n cove re d by PMTC T ( St a n d a rd 1 ) CO U N T R I E S W I T H S K I L L E D B I R T H S At te n d a n ce b e l ow s t a n d a rd ( St a n d a rd < 1 ) 2 Iraq CO U N T R I E S W I T H Ze ro R a p e Ca s e s R e p o r te d i n H I S N R : N o t re l i a b l e N A : N o t ava i l a b l e 7 Nepal Thailand Guinea Yemen Congo Ghana Tanzania Congo (DR) Zambia 9 96 Burundi H ighlights R ep ro du c t i ve H ea l t h : D u r ing the e me rge nc y infl u x o f B u ru nd ians into Tanzania and R wand a in, m inim u m initial s e r v ice p ac k age ( MISP) fo r R e p ro d u c tive he al th ( R H ) was p rov id e d at al l s ite s. No tab l y and as re co mm e nd e d p rac tice, MISP was rap id l y s c al e d u p to co m p re he ns ive R H s e r v ice s within we e ks into the e m e rge nc y in b o th co u ntr ie s. With inc re as e in nu mb e r o f c am p s / re fu ge e ho s ting s ite s, l o gis tic al s u p p o r t fo r re fe rral is a ke y p r io r it y e s p e c ial l y d u r ing e me rge nc ie s. Fo r examp l e, to ave r t a re fe r ral c r is is, UNH CR tim e l y s u p p o r te d p ar tne rs in Tanzania with am b u l ance s. Co o rd inate d wo r k with p ar tne rs s u p p o r te d 13, 939 wo m e n ( 11, 368 in Tanzania and 2, 71 in R wand a) with d e l ive r ie s in. This was as s o c iate d with a s k il l e d d e l ive r y rate o f and 9 re s p e c tive l y.

4 Nutrition & Food Security ANNUAL GLOBAL OVER VIE W Acceptable nutrition status (acute malnutrition) was recorded in 61 work has been highly encouraging, with countries reporting qualita- of all 7 sites surveyed in with a promising 17 of camps regis- tive improvements in attitudes and practices in infant and young tering a significant reduction, whilst remaining high in 39 of sites. child feeding and care practices. The framework activities will be The levels of anaemia amongst young children met targets in only extended to another operations in. 6, however efforts to combat high levels of anaemia resulted in Food assistance for refugees remained a continuing challenge in significant decreases of anaemia in 27 per cent of sites, where trend with 62. per cent of reporting countries in Africa and the data was available. Middle East and North Africa facing cuts in the food basket as of Programmes to prevent malnutrition and anaemia were scaled up. August. Rationalisation of the dwindling resources being allocated to Integral to this strategy was the development of a multisectoral refugee food assistance was maintained through targeting of the infant and young child friendly framework, which was piloted in most vulnerable within camp settings as well as provision of mixed UNHCR operations in 3 countries. The experience of using this frame- cash and in kind food modalities. NUTRITION NUTRITION SURVEYS Proportion of surveyed sites Number of sites with nutrition survey conducted Sites meeting the anaemia standard c Sites meeting the GAM standard a 7.1 Number of sites with nutrition survey conducted Sites meeting the stunting standard b 9 Number of sites included in analyses a) 84, b) 8, c) Countr y over view GLOBAL ACUTE MALNUTRITION Range of propor tions from sur veyed sites Standard of <1 GAM 1 NUMBER OF SUR VEYED SITES COUNTRIES WITH SITES NOT MEE TING STANDARDS H igh l ig hts Nut r it ion & Fo o d S e c u r i t y In 12, nutrition surveys in began to include anaemia as a key indicator, the anaemia levels amongst children 6 9 months old were well above critical levels of 4 (target < ) in the three Congolese refugee camps of Gihembe, Kiziba and Nyabiheke. Stunting levels in the camps were all classified in the serious category and were above 3 (target < ). Global acute malnutrition was low at < In response to these poor nutritional outcomes, the operation embarked on a robust 6 multisectoral action plan to reduce anaemia and micronutrient deficiencies. This included activities such as strengthening linkages between health and nutrition and reproductive health services, improving WASH and environmental conditions, bolstering IYCF, reinforcing Mozambique malaria reduction strategies as well as other vector borne diseases and nutrition sensitive livelihood programmes such as rabbit and chicken rearing. Nutrition surveys in, highlighted how well the indicators had reduced in the 3 years since the implementation of the anaemia reduction action plan. Anaemia reduced by an average of almost 3 and an impressive in the more clinically significant forms of moderate and 9 severe anaemia. In 2 of the 3 camps, stunting reduced from the serious to poor category showing an average drop of 2. Given that stunting is a long term indicator, these results underline just how well the operation has managed to apply the anaemia strategy with impressive results

5 Water, Sanitation & Hygiene ANNUAL GLOBAL OVER VIE W In line with the Global Public Health Strategy, UNHCR is working to al costs and environmental impacts, without compromising on qual- ensure that refugees and persons of concern have access to safe ity. water of sufficient quality and quantity and access hygienic sanita- The average liters per person per day increased to litres with tion services, both at home and at institutions including schools and 43(41.3) sites reporting > litres per person per day and 96 health facilities. (92.3) sites with > litres per person per day. A latrine ratio of This will reduce morbidity and mortality and enhance protection, persons per latrine was achieved globally, with 42(4.4) sites dignity and quality of life. UNHCR WASH programmers promote reporting a latrine ratio of < refugees per latrine and 28(26.9) demand-led approaches that put people rather than engineering at with a latrine ratio < refugees. This is a positive improvement the heart of our interventions. In addition UNHCR is committed to with the year before despite the numerous new refugee emergen- WASH solutions which are efficient at reducing long term operation- cies faced in. WA S H P R O F I L E W AT E R & S A N I TAT I O N T R E N D S Proportion of sites meeting the standard Global average Litres/person/day Person/latrine Litres/person/day 3 Person/latrine AFRICA (11) ME (3) ASIA (1) 9 The figure in brackets represent the number of sites/settlements included in analysis Country overview Jordan WATER ACCESS ( Litres/person/day) (Standard ) 19 SANITATION ACCESS ( Persons/latrine) Iraq (Standard ) COUNTRIES WITH SITES NOT MEETING STANDARDS ( WATER ACCESS < 1 ; SANITATION ACCESS > ) COUNTRIES WITH SITES BORDERLINE ( WATER ACCESS 1-19 ; SANITATION ACCESS 21-) Yemen 2 19 Nepal 26 Thailand Ghana Tanzania 2 H i ghli ghts Wate r, S a n i t at i o n & H ygi e n e UNHCR is reducing operational costs for water supply systems by increasing the number of water pumping facilities powered with photovoltaic (solar) energy. During in Dadaab, 13 boreholes were converted to solar-hybrid energy. After conversion to solar-hybrid, the fuel consumption was Congo (DR) Zambia 28 reduced by, to pump the same amount of water. for refugees in protracted refugee situations. In Partnership 31 UNHCR is improving the sustainability of sanitation services with Gates Foundation, research has been initiated to explore innovative waste to value sanitation solutions that would support more sustainable and efficient operation and management of sanitation solutions, and is considering options for converting waste from refugee camps into valuable by-products such as cooking fuel and compost.

6 United Nations High Commissioner for Refugees Public Health Section Division of Programme Support and Management Rue de Montbrillant 94 CH-11 Geneve Switzerland T: F: The boundaries shown on the maps do not imply official endorsement or acceptance by the United Nations. UNHCR