Attachments
Preface
The Package of High-Priority Health Services for Humanitarian Response (H3 Package) has been developed to define a set of prioritized health interventions that can feasibly be delivered to populations affected by humanitarian crises during protracted emergencies. It has been designed to promote accountability of humanitarian implementers and donors to affected populations and assist with linkages to national service packages. The H3 Package is meant as a starting point, and it should be adapted to fit the local burden of disease, service delivery platforms, and existing health system capacity.
Part I of this guidance describes the rationale for designing a package of health services for a specific humanitarian setting, the scope of the package, and how it should be interpreted and implemented. This includes clarifications on the burden of disease (BoD) profile and health system service delivery capacity that were used as references for the H3 Package development. It provides definitions of default service delivery platforms used in the package, including a description of the anticipated qualifications of health workers at each level.
To support a clear delineation of the minimum services that should be made available in humanitarian settings, the services in the H3 package have been designated as either “core” or “extended.” The "core" high priority package includes services that are locally feasible, cost-effective, and clinically effective. In most settings, extended services require additional investments before they can be delivered as part of a core package (e.g., via increased funding, expanded health workforce, or specialized formal training).
To facilitate and support implementation of the package, services have been assigned to default delivery platforms. The explicit designation of services at well-defined delivery platforms helps ensure that both human and material resources are available at each level of the health system. Based on the expected qualifications of health workers at different levels of care, we have estimated the lowest level of the health care system where a core service should be provided. When capacities and resources allow, core services can be extended to lower levels of care, thereby increasing coverage and accessibility. Some basic services which may not be immediately available at community or outpatient levels have been designated as “core,” as it was assumed that brief training courses for community health workers or nurses would allow those services to be quickly delivered.
The H3 Package was designed to be adapted to fit specific humanitarian settings, and we propose a process for this contextualization. We also reference further guidance on steps for implementation of a package, which includes descriptions on necessary adaptations of the mix of service delivery platforms.
Part II of this guidance provides an overview of the services contained in the H3 Package and provides detailed descriptions of interventions and actions that have been assigned to delivery platforms. Services in the package are organized using a structured and nested architecture that allows for displays of information with increasing levels of detail. Such an organization supports high level visualizations of services to support policy makers, planners and donors in understanding and supporting the scope of services.
The package is organized to provide additional data about the services as well as the resources required to deliver those services. Such granular detail supports implementation of the package by delineating human and material resources needed at each delivery platform. Detailed content also provides a reference for required staffing and medical supplies and supports costing and budgeting.
The H3 Package will be accessible through WHO’s online portal, the Service Package Delivery & Implementation (SPDI) Tool. Using the SPDI Tool, services can be reviewed and customized and additional services included when contextually appropriate.
Additional information also can be found in Annex 1 of this document, which provides details on the methodology used for the selection and categorization of services. Annex 2 provides linkages between medical supplies and equipment required for the H3 Package and for commonly used humanitarian kits.
We hope that the H3 Package will be a useful resource for humanitarian partners and local health authorities in explicitly defining services and resources, reducing fragmentation, and improving the affected population’s access to healthcare services.