GH15-008, HQ Research, Enumerating and monitoring vulnerable sub-populations

项目摘要/摘要 粗死亡率已被公共卫生界用作定义公共健康的基石 紧急情况。通常情况下，紧急情况下的死亡率是由不完整或 调查往往做得不好，在政治上权宜之计时被忽视。该项目将尝试 建立两种不同的技术，都比调查简单，也不太可能被批评者忽视。1) 多源三角测量过程，或建立IDP和死亡统计的敏感度 广泛用于结核病项目和大城市无家可归人口监测的方法，但很少 用于评估死亡率。构建所有已知死亡或国内流离失所者的摘要的过程，收集 独立的样本，并检查两个清单之间的重叠可能会很快，并可能 超越死亡和登记记录中的典型偏见。该项目将选择要列举的地点和 衡量至少一个因急性灾难而流离失所的人口的死亡率，以及至少一个因紧急灾难而流离失所的人口的死亡率 遭受迫害或与重大耻辱有关“。2)以社区为基础的统计代表性 RHA与卫生部在刚果民主共和国菲齐卫生区建立了监测网络。社区 卫生工作者记录了出生、死亡和迁徙事件。初步分析表明，监控 系统检测到93%的出生和87%的死亡，对这两个指标的特异度都是99%，并且是阳性的 98%(出生)和91%(死亡)的预测值。这个项目将尝试看看是否可以有一个类似的系统 在戈马市设立了一个机构，以监测城市环境中的境内流离失所者。虽然不适用于所有危机，但国内流离失所者 内罗毕和约旦以及国内流离失所者几个月或几年保持稳定的其他大城市中心可能 使用这种方法可能会受到监控。一旦确定，从一个 可以很容易地将具有统计代表性的样本添加到监测过程中。 为了最大限度地发挥政策影响，该项目的后几年将涉及与疾病预防控制中心、对外关系与发展办公室、 和其他捐助者，试图建立在这些地点和有 捐助者优先考虑的合作伙伴。如果没有广泛和可信的能力来衡量核心结果，如 在收入、营养不良和死亡率方面，人道主义紧急情况的供资将继续更多地基于 政治利益超过公共卫生需要，成功的救生救援行动将继续存在 与无效的努力没有区别。通过向工具箱中添加两个新的简单而廉价的选项 在人道主义界，我们可以帮助发展一个注重结果而不是进程的社区。

Project Summary/Abstract Crude mortality has been used by the public health community as a cornerstone for defining a public health emergency. Typically mortality in emergencies is monitored by surveillance processes that are incomplete or surveys which are often done poorly and ignored where that is politically expedient. This project will attempt to establish two different techniques, both simpler than surveys, and less likely to be dismissed by critics. 1) The process of multiple source triangulation, or establishing the sensitivity of IDP and death tallies will draw upon methods used widely in TB programs and the monitoring of homeless populations in large cities, but is rarely used to assess mortality. This process of constructing a summary of all known deaths or IDP's, collecting an independent sample, and examining the overlap between the two listings can be rapid, and can potentially transcend the biases typical in death and registration records. The project will select places to enumerate and measure mortality in at least one population displaced by an acute disaster, and at least one population that is persecuted or associated with significant stigma'. 2) A statistically representative community-based surveillance network was established by RHA with the Ministry of Health in Fizi Health Zone, DRC. Community health workers recorded birth, death, and migration events. Preliminary analyses suggest that the surveillance system detected 93% of births and 87% of deaths, with a specificity >99% for both measures, and positive predictive values of 98% (births) and 91% (deaths). This project will attempt to see if a similar system can be established in the city of Goma, to monitor IDPs in an urban setting. While not applicable to all crises, IDPs in Nairobi and Jordan and other large urban centers where IDPs remain stable over months or years could potentially be monitored with this approach. Once established, collection of other desired information from a statistically representative sample could easily be added into the surveillance process. To maximize policy impact, the later years of the project will involve extensive coordination with CDC, OFDA, and other donors in an attempt to establish procedures for mortality measurement in the locations and with partners of priority to donors. Without a widespread and credible capacity to measure central outcomes like income, malnutrition, and mortality, funding of humanitarian emergencies will continue to be based more on political interests than on public health need, and successful life-saving relief operations will remain indistinguishable from ineffective efforts. By adding two new simple and inexpensive options to the toolbox of the humanitarian community, we can help develop a community focused on outcomes instead of processes.