Strengthening health disaster risk management in Africa : multi-sectoral and people-centred approaches are required in the post-Hyogo framework of action era

摘要

BACKGROUND : In November 2012, the 62nd session of the Regional Committee for Africa adopted a comprehensive10-year regional strategy for health disaster risk management (DRM). This was intended to operationalize the WorldHealth Organization’s core commitments to health DRM and the Hyogo Framework for Action 2005–2015 in thehealth sectors of the 47 African member states. This study reported the formative evaluation of the strategy,including evaluation of the progress in achieving nine targets (expected to be achieved incrementally by 2014,2017, and 2022). We proposed recommendations for accelerating the strategy’s implementation within the SendaiFramework for Disaster Risk Reduction.METHODS : This study used a mixed methods design. A cross-sectional quantitative survey was conducted alongwith a review of available reports and information on the implementation of the strategy. A review meeting todiscuss and finalize the study findings was also conducted.RESULTS : In total, 58 % of the countries assessed had established DRM coordination units within their Ministry ofHealth (MOH). Most had dedicated MOH DRM staff (88 %) and national-level DRM committees (71 %). Only 14(58 %) of the countries had health DRM subcommittees using a multi-sectoral disaster risk reduction platform.Less than 40 % had conducted surveys such as disaster risk analysis, hospital safety index, and mapping of healthresources availability. Key challenges in implementing the strategy were inadequate political will and commitmentresulting in poor funding for health DRM, weak health systems, and a dearth of scientific evidence onmainstreaming DRM and disaster risk reduction in longer-term health system development programs.CONCLUSIONS : Implementation of the strategy was behind anticipated targets despite some positive outcomes,such as an increase in the number of countries with health DRM incorporated in their national health legislation,MOH DRM units, and functional health sub-committees within national DRM committees. Health system-based,multi-sectoral, and people-centred approaches are proposed to accelerate implementation of the strategy in thepost-Hyogo Framework of Action era.