Strengthening Community Based Health Care Provision Capacity is Critical for Emergency Preparedness – Lessons from Iraq and Uganda

Rumishael Shoo* and Geoffrey Acaye

Strengthening Community Based Health Care Provision Capacity is Critical for Emergency Preparedness – Lessons from Iraq and Uganda

Women, children and the poor constitute the most vulnerable groups in emergencies.
Continuity of delivery of services at the community level is critical in preventing morbidity and
mortality. Insecurity and other disasters reduce access to public health services. Conventional
emergency preparedness emphasizes community capacity development after a disaster to build
resilience and thereby mitigate against effects of a similar occurrence in the future. Lessons
from Iraq and Uganda seem to indicate that this should be addressed as part of preparedness.
Our review of the context in two completely different settings supports this view. We present
here, work undertaken in Iraq to strengthen community level Maternal Newborn and Child
Health (MNCH) provision before the insecurity following the invasion by Islamic State of Iraq
and Syria (ISIS) and experiences from Northern Uganda during the insecurity caused by the
Lord’s Resistance Army and Ebola Disease outbreaks.

In 2013 the Ministry of Iraq decided to use Traditional Birth Attendants (TBAs) as a
strategy to reach the unreached mothers. TBAs are usually mature women in society who attend
to deliveries but are often consulted for other health matters. TBAs are considered a vital link
with the formal health services. Available evidence shows that TBAs can prevent some perinatal
deaths if well prepared.1There is also emerging evidence that deployment of adequate numbers
of well trained and supported cadres at the community level can improve Maternal and Child
health practices especially those related to postnatal care and early initiation of breastfeeding.2
Experiences in Malawi with Health Surveillance Assistants and use of community volunteers in
Zimbabwe during the cholera outbreaks show they can also have significant impact in controlling communicable diseases outbreaks.

Emerg Med Open J. 2015; 1(1): 15-16. doi: 10.17140/EMOJ-1-104

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