herams尼泊尔2024年9月洪水和山体滑坡信息图

Floods and landslideaffected areasKoshiTABLE OF CONTENTSPages 6-11Pages 18-23InfographicInterpretation guideHeRAMS servicedefinitionsPages 3-5Pages 30-34 Disruptions to health systems can impede availability and access to essential health services. A lack of reliable information prevents sounddecision-making, increasing a community’s vulnerability to morbidity and mortality, especially in rapidly changing environments that requirecontinued monitoring. The Health Resources and Services Availability Monitoring System (HeRAMS) aims to provide decision-makers and healthstakeholders with vital and up-to-date information on the availability of essential health resources and services, helping them to identify gaps anddetermine priorities for intervention. This is accomplished by evaluating the availability of health services using standardized definitions adaptedHeRAMS was deployed in Bagmati, Koshi and Madhesh provinces following the severe flooding and landslides that affected these provinces inSeptember 2024. The analysis presented here provides insights into the status of78 health service delivery units (HSDUs)1, across the threeprovinces, based on data reported as of 31 January 2025. It is important to note that the deployment of HeRAMS is ongoing, including data verifi-cation and validation. Hence, this analysis is not final and was produced solely for the purpose of informing operations. Furthermore, the analysiswas restricted to HSDUs directly affected by the earthquake. Thus, this report does not provide an exhaustive analysis of the operational statusand the availability of health services and resources in the affected districts.The HeRAMS data modelHeRAMS provides a high-level, indicator-based snapshot of the health system status. Definitions are aligned with established standards to facili-tate data integration and harmonization. Each indicator is assessed through two key questions:1.What is the availability level of the service?2.If partially or not available, what barriers impede service delivery?Availability:is defined as the service being present in sufficient quality and quantity to meet the daily demands of the HSDU. A resource orservice is considered “available” only if the HSDU has the necessary means to deliver it in accordance with national standards. Availability is●Available:The service is present in sufficient quality and quantity to fully meet the daily demands of the HSDU. Necessary staff andresources are in place to deliver it in accordance with national●Partially available:The HSDU is able to provide some partsof the service but due to current constraints, has insufficientcapacity or resources to meet daily demand, or is unable toprovide the full service in accordance with national standards.●Not available:The HSDU is expected to provide the servicebut, due to current constraints (such as insufficient resourcesor staff), is unable to deliver it at all.●Not normally provided:The service falls outside of the cur-rent package of services the HSDU aims to provide.Expected versusnot expectedFocal points specify for each service whether an HSDU anticipates providing it. “Expected” indicates that the HSDU plans to offerthe service, regardless of its current availability status—whether available, partially available, or unavailable. Conversely, “notexpected” means the HSDU does not plan to provide the service, even if all obstacles were removed, and the service is considered“not normally provided.” This categorization is based on the HSDU’s perspective and current circumstances and may differ fromassumptions based on national service packages.1Rather than health facility, HeRAMS uses the term health service delivery unit (HSDU) to include any modality through which healthcare services may beprovided such as health centres, clinics, hospitals, mobile clinics, temporary or emergency structures, and in some cases individual providers such ascommunity health workers.HeRAMSNepalInfographic interpretation guideLack ofequipmentLack oftrainingsuppliesLack ofstaffMAIN BARRIERSWhat are the main (max. 3) barriers impeding availability?AvailablePartiallyavailablePartiallyavailableNot availableAVAILABILITYIs the service available? Backgroundto the local context.categorized as follows:standards. 3Lack of financialresourcesLack ofNot normallyprovided 4Whenever an indicator is not available up to standard (partially or not available),barriersimpeding service availability are systematicallycollected using the following categories:●Lack of staff●Lack of training●Lack of equipment●Lack of (medical) supplies●Lack of financial resourcesInfographic contentOverall considerationsThe initial section of the infographic provides an overview of the overall status of HSDUs and includes all reporting HSDUs in HeRAMS, whilesubsequent analyses focus exclusively on HSDUs that are at least partially operational. The analysis of individual services excludes HSDUsreporting a service as “not normally provided.” As a result, t