Technical consultation on the health component of post-disaster and postconflict needs assessment and recovery planning

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1 Technical consultation on the health component of post-disaster and postconflict needs assessment and recovery planning April 2011 Granada, Spain 1

2 Objectives of the Consultation The World Health Organization (WHO) and the Andalusian School of Public Health, Granada, (EASP) organized a global consultation to review and improve the methodologies for the health component of post-conflict and post-disaster needs assessments and the following recovery planning process. The meeting brought together 36 experts representing different stakeholders involved in the health component of PCNA and PDNA, with the aim of analysing previous experiences and deriving lessons from them. Participants included representatives from WHO, UNICEF, UNFPA, UNDP, the World Bank, ECHO, as well as members of NGOs, academic experts in the field, and government representatives from countries that have conducted these processes in recent years. The experiences of Haiti, Liberia, Sudan and the Philippines were reviewed in detail.. 2

3 Recovery after Natural Disasters and Complex Emergencies Triggering Event Type of damage Area / population affected Natural disasters Acute Mainly physical infrastructure, loss of HR Often a region or limited area / the affected population a minor share of total Complex emergencies Chronic Both physical and institutional infrastructure; breakdown of health systems It can affect vast areas & regions / substantial share of population directly or indirectly affected Impact on national capacity Capacity at central level preserved, but can be overwhelmed in major disasters After a chronic crises, it tends to collapse completely 3

4 PDNA "A special (integrated) type of recovery and reconstruction assessment; the coming together of the different recovery perspectives, with the respective roles of the United Nations, the EC, the WB and their development partners supporting a government-led assessment process. A PDNA pulls together information into a single, consolidated report, information on the physical impacts of a disaster, the economic value of the damages and losses, the human impacts as experienced by the affected population, consequences for governance systems, and the resulting early and long-term recovery and reconstruction needs and priorities." 4

5 PCNA "A complex analytical process led by the national authorities and supported by the international community and carried out by multilateral agencies on their behalf, with the closest possible collaboration of national stakeholders and civil society. The needs assessment aims to overcome consequences of conflict or war, prevent renewed outbreak and shape the short-term and potentially mid-term recovery priorities as well as articulate their financial implications on the basis of an overall longterm vision or goal." 5

6 National Leadership National ownership as key to reach agreement between different groups and sectors PCNAs and PDNAs to follow on request of and to be led by national government National capacity might be limited Assessments often carried out by international aid system Implications: Lack of national ownership may create barrier for its later implementation 6

7 Political and economic factors PDNAs and PCNAs not only technical but also political processes This may be even more the case for PCNAs, due to presence of different parties and rebel groups Importance of analysis and understanding of political economy Risk of reproducing old political structures that were at the root of the crisis Political economy less relevant for post disaster recovery However, need to address inequities in access to health care etc. during recovery 7

8 Linking PDNA and PCNA recovery planning with other planning processes PCNAs and PDNAs to find balance between humanitarian response strategies and recovery planning Overlap between purpose of Consolidated Appeal Processes and PCNA/PDNA processes CAP as important coordinating tool for humanitarian sector Barriers to implementation of recovery framework Discrepancy between identified needs and donor priorities Lack of linkage with national development plans 8

9 Role of stakeholders and coordination Formal agreement between United Nations Development Group, European Commission and the World Bank Balance between efforts to include as many stakeholders as possible and the high opportunity costs of doing so Inclusion of all stakeholders may be postponed to a later stage PCNAs and PDNAs often take place in parallel structure to the humanitarian cluster approach Need to link PCNA/PDNA with existing coordination structures instead of creating own mechanism 9

10 Aid, aid instruments and resource mobilization PDNAs and PCNAs driven by the need for costing of recovery Needs assessments not associated to implementing agencies appeals Linkage of PDNAs/PCNAs to multi-donor trust funds creates perception of MDTF to be implementing arm PDNAs and PCNAs seem to have a short life after donor conference Need to link more closely with national development plans 10

11 Conclusions/ Recommendations PCNA and PDNAs are not and should not be perceived as planning instruments in isolation. They are not self-contained exercises. However, they are often conducted as such. We have to set some boundaries to the PDNA and PCNA exercise and manage expectations of all actors - national governments, international partners and donors and be realistic, pragmatic and modest. We need to establish sound clear links between humanitarian undertakings and recovery. Ways to ensure connections are linkages of appeals with recovery plans, linking PDNA and PCNAs with the health cluster work Foster the discussion of these linkages at the time of the development of the humanitarian strategy. 11

12 Conclusions/ Recommendations National leadership has to be strengthened, particularly by dovetailing the PCNA and PDNA with the national investment plans. The recovery plan should serve as a catalytic force to inform and modify the national plan. We should take into account of the complexity of the international architecture (humanitarian and developmental) and the political economy of recovery at country level. We need to ensure primacy of the health system logic in the health component during the assessment. 12

13 Conclusions/ Recommendations There is a need for increased efforts in advocacy dissemination of these processes and tools that include national actors, schools of public health, economy and social sciences. This will also contribute to capacity building. We need more lessons learnt exercises and a meta-analysis to gather evidence of the experiences (sectoral and global) of PCNA and PDNAs. There are many common approaches (using systemic logic) that can be applied to both PCNA and PDNA. At the same time the difference is in scope depth and methods of applications need to be highlighted in guidance notes. There is a need for a reasonable exit strategy for humanitarian operations especially in post conflict situation. CHAPS and CAPs form the planning platform for emergencies and humanitarian work in humanitarian settings. These types of platforms are absent from the recovery exercise together with its alignment with national plans. We need clear transition strategies taking into consideration the changes in funding streams. 13

14 Commitments Finalize health sector guidance methodologies for PCNAs and PDNAs with the inputs of the consultation Build an informal network for lessons learned and guidance development 14