19th PHEMAP - Development of Preparedness Plan - MDA

TRAINING
PACKAGES FOR 01\

HEALTH EMERGENCIES
Public Health and Emergency

Management in Asia and the Pacific
National PHEMAP
Module V
Disaster Risk Reduction and
Management in Health Planning
Public Health and Emergency Management in Asia and the Pacific National
Training Packages for
Health Emergencies 01\
Module Objectives
After the module, participants will be able to:

1. Discuss the importance of planning and relevance of
plans in disaster risk reduction and management in
health (DRRM-H);
2. Distinguish the different DRRM-H plans;
3. Gain thorough understanding of the content and process
in developing the DRRM-H plans; and
4. Outline steps in successful plan implementation.
Session 1
INTRODUCTION TO
DRRM-H PLANNING
Session Objectives
At the end of this session, participants should be able

to:
1. Discuss the rationale and basis for DRRM-H
planning;
2. Discuss the principles of DRRM-H planning;
3. Describe the content of the Health Emergency
Preparedness, Response and Recovery Plan
(HEPRRP).
Sendai DRR Framework
Substantial reduction of disaster

risk and losses in lives,
livelihoods and HEALTH and in
the economic, physical, social,
cultural and environmental
assets of persons, businesses,
communities and countries.
HEMB Strategic Plan 2017-22
• Vision
“Health disaster safety in the hands of the
people”
• Mission
To support community disaster resilience
• Goal
To decrease damages and losses to lives and
health –related properties in the community
Bangkok Principles for Implementation of the
Health Aspects of the Sendai Framework
“Promote systematic integration of health into

national and subnational DRR policies and plans
and the inclusion of emergency and DRM
programmes in national and subnational health
strategies.”
SDGs and DRRM-H
• 3.d Strengthen the capacity of all countries, in particular
developing countries, for early warning, risk reduction and
management of national and global health risks.
Indicators:
qDRRM-H plans that are approved, tested and
revised/updated
qTrained, organized and equipped health emergency
managers
qFunctional command, control, coordination and
communication systems
Plan Definition
• A method for achieving an end

• An often customary method of doing
something
• A detailed formulation of a program of action
Merriam-Webster
What kinds of plans do you Know? Use?

Prepare?
Why plan in emergencies and disasters?
• To achieve goal of saving lives, decreasing deaths,
diseases, injuries
• To fulfill mandates and address requirements
• To develop systems for managing emergencies and
disasters
• To build capacities for response
• To foster resilience of systems ensuring sustainable
development
• To maximize access to resources
• To link the actions of different agencies and actors in
different sectors
Planning and DRRM-H
H V R C
HAZARD HAZARD PREVENTION/MITIGATION

VULNERABILITY VULNERABILITY REDUCTION
RISK RISK REDUCTION
CAPACITY CAPACITY DEVELOPMENT
Principles of DRRM-H Planning
• Plans should be in accordance with existing national
policies
• “All hazards approach”
• “Worst case scenario” including ‘octopus effect’ (loss
of command and control)
• Continuous and integrated process
• Multisectoral
• Internal/external
• Should be based on agreed set of arrangement for
responding to and recovering from emergencies and
disasters.
What are DRRM-H plans?
– Agreed set of arrangements for
• Preventing,
• Preparing for,
• Responding to, and
• Recovering from emergencies
– Involve the description of

• Responsibilities
• Management structures
• Resource and information management
• SOPs
– Plans that focus on protecting life, property, essential

services delivery, the economy and the environment
What we plan for?
Disaster Management is:
80% generic 15% specific 5% unique
to all disasters to the hazard to the event
1. Organization
EOC earthquake time
coordination large numbers of trapped and injured place
communications large numbers of homeless and displaced weather
transport large numbers of dead and missing
logistics and supplies geography
information and media dead, injured and missing staff climate
reporting and surveillance damaged critical infrastructure / resources (hospitals, vehicles)
loss of water, gas, electricity, phone, transport, fuel networks security
2. Response loss of road, sea, air, rail infrastructure / access
search and rescue politics
evacuation long period of SAR, victim extraction economy
mass casualty management high demand for FA, stretchers, triage, medical transport governance
management of dead and missing high demand for beds, surgery, blood products, referral
security wound infections, amputations, tetanus, dust inhalation emergency management capacity
temporary shelter, clothing and utensils high demand for orthotics, prosthetics, disability, dental logistics capacity
emergency water, sanitation and energy demand for specialized spinal and head injury care disposal of inappropriate donations
emergency food supplies high demand for temporary shelter, food, utensils, stoves,
emergency public and environmental health water, energy, clothing, tents, blankets leadership
emergency engineering and public works high demand for psychosocial support of victims and staff solidarity
management of donated supplies / foreign teams morale
3. Recovery few outbreaks of communicable diseases corruption

variable demand for medicines and equipment crime
curative and public health care (acute / chronic injury care - high, infectious disease - low, looting
education potentially unstable chronic disease - medium)
agriculture compensation claims
trade and commerce contamination of water, air and soil insurance claims
toxic chemical, sewerage and gas leaks / spills
4. Rehabilitation and Reconstruction urban fires, explosions ownership disputes
people contaminated, infested and unsafe foods property disputes
property increased vector breeding
services
livelihoods loss of livelihoods, markets, distribution networks
environment
What do DRRM-H plans answer?
• What might happen?
• When it might happen?
• Where it might occur?
• How big it might be?
• What effects it might have?
• How long it might last (emergency period + recovery
period)?
• What are the strategies to respond and recover?
Philippine Disaster Plans
How the DRRM Plans connect?
National Plan Sectoral
Plans
Hazard
Regional Plans
Specific
Plans
Agency-
Specific Plans
(Hospitals)
Community Plans
Intersectoral in nature
What are the different DRRM-H Plans?
• Health emergency preparedness, response and

recovery Plan (HEPRRP)
• Contingency Plan
• Business Continuity Plan
What is the HEPRRP?
• Health Emergency Preparedness, Response and Recovery
Plan
• Tool for disaster risk reduction
– To prevent, prepare, respond, recover
• Linked to the NDRRM Plan
• Contributory to the attainment of NOH
– Better health outcomes in emergencies and disasters
• Required by DOH and LGUs
• Integral component of HEM institutionalization
• Integrated in scorecards for M&E of local health systems
• Required to access the local calamity funds
The HEPRRP
Includes:
1. A Prevention and Preparedness Plan:
• Hazard prevention/mitigation plan
• Vulnerability reduction plan
• Capacity development/emergency preparedness plan
2. An Emergency Response Plan with:
3. An Emergency Recovery and Rehabilitation Plan
Elements of Health Emergency Preparedness, Response,
And Recovery Plan
I. Background
II. Plan description/definition
III. Goals and objectives
IV.Planning Group
V. Risk Reduction Plan
• Hazards prevention
• Vulnerabilities reduction
• Emergency Preparedness Plan
And Recovery Plan
VI. Management Structures

VII.Roles and responsibilities
VIII.Emergency Response Plan
• Policies, guidelines, protocols for the developed systems
• Plan of action on the first 2 hours, 2 to 12 hours, and
after 24 hours from the time of emergency
IX. Recovery and Reconstruction Plan
And Recovery Plan
X. Annexes
– Glossary
– Abbreviations
– Hazard Maps
– Flow Charts
– Directory of contact persons
– Inventory of resources or assets of hospital and partner
agencies
– Regional/Office Orders for health emergency
– management
HEPRRP in LGU Scorecard
qAvailable
qSigned/approved
qIntegrated in local DRRM Plan
qFunded
qTested through drills
qRevised/updated
Will soon be included as part of DILG Seal of Good Local Governance
Session 2
PREVENTION AND PREPAREDNESS
PLANNING
Session Objectives
At the end of this session, participants should be able to:

1. Discuss the rationale for prevention and preparedness
planning;
2. Describe the contents of the hazard and vulnerability
reduction and capacity development plan;
3. Apply understanding of concepts of prevention and
preparedness in the context of a plan.
A Logical Framework of Terminology (the relationships between the key words)
Hazard Risks
Any potential threat to public Anticipated consequences of a
safety and/or public health specific hazard interacting with a
specific community (at a specific
time)
Emergency Vulnerabilities
An actual threat to public safety Factors which increase the risks
and/or public health arising from a specific hazard in a
specific community (risk modifiers)
Disaster Capacities
Any actual threat to public safety An assessment of ability to manage
and/or public health where to an emergency (a risk modifier) –
local government and the total capacity is measured as
emergency services are unable readiness
meet the immediate needs of
the community
Community is people, property, services, livelihoods and environment i.e. the elements
exposed to hazards
The HEPRRP
Includes:
1. A Prevention and Preparedness Plan:
• Hazard prevention/mitigation plan
• Vulnerability reduction plan
• Capacity development/emergency preparedness plan
2. An Emergency Response Plan with:
3. An Emergency Recovery and Rehabilitation Plan
Impact Focus Risk Reduction Plan
Hazard
Hazard Reduction Plan
Reduced (What will you do to reduce
exposure exposure to hazard?)
Vulnerability
Vulnerability Reduction Plan
Decreased (What will you do to reduce
vulnerability community’s vulnerability?)
Community
Community Preparedness /
Prepared Capacity Development Plan
Community (What will you do to increase
community’s capacity to respond)
Reduced Risk Reduction Plan

Risks
Risk (What will you do to reduce risk?)
Hazard Prevention/Mitigation Plan
• Plan to reduce exposure to hazards

– not all hazards are predictable or preventable
• Strategies/activities to prevent exposure to hazard
• Examples: evacuation, early warning systems,
surveillance systems, PPEs, safety practices, public
awareness, health promotion
HAZARD ASSESSMENT
Hazard assessment is a process of identifying all the

possible hazards that have the potential to affect the
community.
This is to give an idea of the:
– possible areas to be affected,
– to predict the vulnerabilities of such areas, and
– anticipate the possible consequences or risks of such
hazards on these areas.
Hazard Assessment
1. Identify all the possible hazards that have affected or have

potential threat in your community/area/hospital.
2. Prioritize hazards based on:
Scale of 1 – 5, with 5
A. Severity
as the highest, RATE
B. Frequency each hazard
C. Extent
D. Duration Formula:
E. Manageability (A +B +C+ D) - E
3. Arrange the hazard score highest score = highest priority
4. Translate into a hazard map
Example
Hazard Assessment
Hazard Severity Frequency Extent Duration Manageab TOTAL
ility
Flood 3 4 5 1 4 9
Fire 5 1 5 3 1 13
Translate into a Hazard Map
Hazards Areas commonly affected

Fire Kitchen, CSR
Flood ER, Lobby
Hazard Analysis
Make the hazard assessment analysis of your

area:
– Identify the hazards
– describe the hazards
– describe the effects to the community
– prioritize the hazards
– identify the areas that will be affected
– Develop your hazard map
Translate into a hazard map
•Layout/map/plot:
– Provinces/municipalities/cities etc.
– Areas in the hospitals/agency/institution
• Identify areas exposed to the hazards
• Code each hazard
• Place a legend
Example of Hazard Map
HAZARD PREVENTION/
MITIGATION PLAN
Hazard Strategies Time Resource Requirement
/ activities Frame
Person Indicators
responsible
Typhoon Early Q2, 2016 Space, manpower, equipment HEMS Opcen
warning Coordina establish
and alert tor ed
system
through
set-up of
Opcen
ANATOMY OF COMMUNITY RISK MANAGEMENT
community readiness Community
hazard Ì Ì multisectoral, all hazards = risk
vulnerability
indicators: indicators: indicators: indicators:
probability People: risk of:
scale/magnitude/ policy, plans, procedures
access to health care death
strength/intensity measles vaccination knowledge, skills, attitudes
spread resources injury (mental/
under 5 nutrition physical)
duration under 5 mortality
legislation disease
access to clean water (mental/physical)
biological hazards: access to sanitation national & sectoral policy
season, infectivity, adequate housing administrative procedures
latency, transmission loss of life
employment/ income response & recovery plans displacement
resistance, etc. female literacy preparedness plans loss of property
natural phenomena technical guidelines loss of income
famine Property: management structure
diseases of epidemic health infrastructure institutional managements
potential secondary hazards
vehicles information systems breakdown in security
events/crowds medical supplies warning systems damage to infrastructure
infestations human resources breakdown in services
transport accidents Services: material resources Contamination
structural failures curative care services financial resources
industrial accidents ambulance services simulations & training
chemical accidents public health services education
Pollution health info system public information
refugees community participation
war Environment: research
terrorism water/soil/air quality
Prevention & Mitigation
Ì Emergency Preparedness
Ì Vulnerability Reduction = Community Risk
Programme Programme Programme Management
Goal Focus Risk Reduction Plan
Hazard
Vulnerability
Community

Risks
• Plan to reduce the consequences of exposure to

hazards
• Identify vulnerabilities specific to the five elements of
the community (5 Ps)
– People, Property, Services, Livelihood, Environment
• Strategies/activities to reduce the vulnerabilities
• Building resilience of the community to withstand
impact and consequences of a hazard
Vulnerability Analysis
Based on the identified hazard

• Determine the vulnerabilities of each of the 5 elements of
the community for each hazard
– People - Livelihood
– Property - Environment
– Services
• If the objective is to only look at one element, the analysis
will be done only for that element
• f the objective is to assess the community vulnerability, all
five elements should be analyzed separately
Example
2. Vulnerability Assessment
Hazard Vulnerable Vulnerabilities
Areas
People Properties Services Environment Livelihood
Flood Navotas Over Houses Low lying Poor waste No other
crowding made of light sites of management source of
materials health and income aside
centers sanitation from fishing
Hazard Vulnerabilit Strategies Time Resource Requirement Person Indicators
y / Activities Frame Responsible
Earthqu People Drill Q2 and Funding, scenario, HEMS Drills

ake – with Q4, evaluators Coordinat organiz
extreme emphas 2016 or ed
s of is on
ages evacuati
on of
elderlies
and
children
Propert Structur Q3, Funding HEMS Assess
y – old al 2016 Coordinat ment
building assess or conduct
s ment ed
vulnerability
legislation disease
Impact Focus Risk Reduction Plan
Hazard
Vulnerability
Community

Risks
Capacity Development or Preparedness Plan
• Guide towards building the capacity of the

agency/institution/hospital to effectively or efficiently
respond to emergency or disaster
• Building capacity to manage risks or capacity to
respond to and recover from emergency
Risk Assessment
• process of analyzing or anticipating the

possible consequences of a hazard once it has
affected the community
– identify the risks or probable consequences to the
public health and safety of a community/agency
being exposed to the hazard
Risk Assessment
Hazards Vulnerabilities Risks

Typhoon House made of Probability of death
light materials Probability of spread of the disease
Prob. of disease or injury (mental,
House near physical)
coastline
Prob. of contamination
Prob. of displacement
Prob. of loss of income or property
Prob. of breakdown in security
Prob. of breakdown in essential
services
Risk Capacity Strategi Time Resource Requirement Person Indica-
es / Frame Resp. tors
Activitie
s
Death Basic Life BLS Q3, 2016 Funding, trainers, module HEMS BLS
due to Support Training Coordina training
drownin skills tor conducte
g d
Mental Referral Mental Q2, 2016 Directory Mental Mapping
health system for health Mental health facility/hospitals Health of MH
problem special professio Coordina professio
s cases nals tor nals
mapping done
Damage WASH WASH Q4, 2016 WASH manual of operations WASH WASH
d to assessme cluster Funding, WASH logistics Coordina cluster
water nt and meeting tor meeting
facilities cluster conducte
causing coordinati d with
contami on agreeme
nation mechanis nts
ms
vulnerability
legislation disease
10 Ps Strategies in Preparedness
1. Policies, Protocols, Procedures, Guidelines

2. Plans
3. People
4. Partnership Building
5. Program development
6. Physical infrastructure development
7. Practices
8. Peso and Logistics
9. Promotion and Advocacy
10. Performance management
Workshop 1
Per hazard group, develop your:

1. Hazard prevention/mitigation plan
2. Vulnerability reduction plan
3. Capacity development/preparedness plan
HAZARD PREVENTION/
MITIGATION PLAN
Hazard Strategies Time Resource Requirement
/ activities Frame
Person Indicators
responsible
Hazard Vulnerabilit Strategies Time Resource Requirement Person Indicators
y / Activities Frame Responsible
Risk Capacity Strategi Time Resource Requirement Person Indica-
es / Frame Resp. tors
Activitie
s
Session 3
RESPONSE PLANNING
Session Objectives

to:
1. Discuss the rationale for response planning;
2. Describe the contents of the response plan;
3. Apply understanding of response systems in the
context of a plan.
Reasons for Emergency Response Plans
Protect life,
property &
environment,
essential services
Make the best Create systems
use of available and networks for
response and
resources Emergency recovery
Response Plan
Promote
Link response cooperation
with recovery between sectors
and agencies
Emergency Response Plan
• Use of existing capacities to deliver relief or response

• Mobilization of resources
• Use of developed systems for emergency
management
• Actual implementation of guidelines for the
developed systems
Preparedness to Goal
(Framework for Implementation and M and E)
Input Output Outcome Impact
Emergency Prepared
Effective Low morbidity
Preparedness Communities
Response Low Mortality
Program 10 Ps
Can manage:
•incident
•victims
•Services
•Environment
•information
Workshop 2
You will be divided into 5+1 groups following the
Response Framework.
Your Operation Center (LGU) received a report of a
typhoon. What will be your actions:
1. Prior to impact with the objective of “preventing loss
of lives and minimizing impact to health system”
2. In the first 0 – 48 hours with objectives of “saving as

much lives as possible”
3. 48 hrs. – end of 1st week – “Prevention and control

of post – disaster morbidities”
Response Plan
WHEN MANAGEMENT WHAT WHO HOW
(Activities) (Person
(Timeline) SYSTEMS (Procedures,
Resp) SOPs)
(Triggers,
Criteria)
Pre-Impact Managing the:
Impact 1. Incident/event
0 to 48
2. Victims
ANSWER THESE
hours
3. Service Convert to flowcharts or

Post-
providers enumerate in bullets
Impact
>48 hours Narrate
4. Information
5. Resources
(non-human)
Contingency planning
• Is undertaken specifically for an emerging or anticipated

crisis.
• this may be a new situation or a potential deterioration in
an existing situation to which the international
humanitarian community must respond
• Hazard-specific
• It is scenario-based
Contingency planning is a process that includes:
• Analyzing potential emergencies;
• Analyzing the potential humanitarian impact and

consequences of identified emergencies;
• Establishing clear objectives, strategies, policies and

procedures and articulating critical actions that must be
taken to respond to an emergency
Business continuity planning (BCP)
A plan that describes a sequence of actions, and the

parties responsible for carrying them out, in response to
a series of identified risks, with the objective of
restoring normal business operation as soon as possible.
Business Continuity Plan (BCP)
• Enables critical services to be continuously delivered to

clients without interruption
• Contains logistical plan with strategies, mechanisms,

arrangements, systems, and procedures on how to
continue operations in order to deliver the critical
services
• Includes support to operation in terms of resources such

as manpower, logistics, finances, information, lifelines,
and accommodations, among others
Session 4
RECOVERY AND REHABILITATION
PLANNING
Session Objectives

to:
1. Discuss the rationale for recovery and rehabilitation
planning;
2. Describe the contents of the recovery and
rehabilitation plan;
3. Gain thorough understanding of recovery and
rehabilitation in the context of a plan.
Recovery and Rehabilitation Plan
A plan to restore services and replace damaged
elements of the health system for the better
• Repair/construct damaged buildings and utilities

• Replace hospital supplies and equipment
• Psychosocial services for evacuees, personnel
and even leaders
• Return to normal activities of the office/health
facility
• Post-Incident Evaluation, Lessons Learned, Plan
for review and amendments
Recovery and Rehabilitation Plan
Strategies / Activities Time Frame Resources Person Indicators
Responsible
Repair of damages May 2016 Funding City Damages

engineer repaired
Replenishment of May 2016 Additional logistics HEMS Buffer
logistics from Regional Office Coordinator stock
maintained
Conduct of MHPSS June 2016 Funding, trainers, MHPSS MHPSS
session for staff module coordinator session
conducted
Conduct of Post- July 2016 Funding, facilitators HEMS PIE
Incident Evaluation coordinator conducted
Session 5
PLANNING FOR IMPLEMENTATION
Successful Plan Implementation
1. Write the Plan and have it approved by the head of

the agency. The Plan is not a plan until written and
approved by the head of agency
2. Disseminate the plan to all the stakeholders and
staff. Everyone needs to know the plan so that in
emergency no one would ever say, “he does nothing
cause he knows nothing”.
Successful Plan Implementation
3. Test the plan. The plan is believed to be effective

only when it is tested, be able to know its
functionality, acceptability, and doability in the
hands of the implementers.
4. Implement the plan.
5. Monitor and evaluate the implementation of the plan
6. Review and update the plan regularly.
Pointers in Successful Plan Implementation
• Write it down or it will not be remembered

• Make it simple or it will not be understood
• Disseminate it or it will not be in the hands of those
who need it
• Test it or it will not be practical
• Revise it or it will not be up – to – date
Module Objectives
After the module, participants will be able to:

1. Discuss the importance of planning and relevance of
plans in disaster risk reduction and management in
health (DRRM-H);
2. Distinguish the different DRRM-H plans;
3. Gain thorough understanding of the content and process
in developing the DRRM-H plans; and
4. Outline steps in successful plan implementation.

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TRAINING

PACKAGES FOR 01\

Public Health and Emergency

After the module, participants will be able to:

At the end of this session, participants should be able

Substantial reduction of disaster

“Promote systematic integration of health into

• A method for achieving an end

What kinds of plans do you Know? Use?

HAZARD HAZARD PREVENTION/MITIGATION

– Involve the description of

– Plans that focus on protecting life, property, essential

3. Recovery few outbreaks of communicable diseases corruption

• Health emergency preparedness, response and

VI. Management Structures

Will soon be included as part of DILG Seal of Good Local Governance

At the end of this session, participants should be able to:

Reduced Risk Reduction Plan

• Plan to reduce exposure to hazards

Hazard assessment is a process of identifying all the

1. Identify all the possible hazards that have affected or have

Translate into a Hazard Map

Hazards Areas commonly affected

Make the hazard assessment analysis of your

Reduced Risk Reduction Plan

• Plan to reduce the consequences of exposure to

Based on the identified hazard

Earthqu People Drill Q2 and Funding, scenario, HEMS Drills

Reduced Risk Reduction Plan

• Guide towards building the capacity of the

• process of analyzing or anticipating the

Hazards Vulnerabilities Risks

1. Policies, Protocols, Procedures, Guidelines

Per hazard group, develop your:

At the end of this session, participants should be able

• Use of existing capacities to deliver relief or response

Input Output Outcome Impact

2. In the first 0 – 48 hours with objectives of “saving as

3. 48 hrs. – end of 1st week – “Prevention and control

3. Service Convert to flowcharts or

• Is undertaken specifically for an emerging or anticipated

• Analyzing potential emergencies;

• Analyzing the potential humanitarian impact and

• Establishing clear objectives, strategies, policies and

A plan that describes a sequence of actions, and the

• Enables critical services to be continuously delivered to

• Contains logistical plan with strategies, mechanisms,

• Includes support to operation in terms of resources such

At the end of this session, participants should be able

• Repair/construct damaged buildings and utilities

Repair of damages May 2016 Funding City Damages

1. Write the Plan and have it approved by the head of

3. Test the plan. The plan is believed to be effective

• Write it down or it will not be remembered

After the module, participants will be able to:

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