• Health Seeking Behaviour in Kamrangirchar

      Jeroen van der Heijden; OCA (2018-09-28)
    • Health Service Access Survey among Non-camp Syrian Refugees in Irbid Governorate, Jordan

      Rehr, Manuela; Shoaib, Muhammad; Deprade, Anais; Lenglet, Annick; Ait-Bouziad, Idriss; Altarawneh, Mohammad; Alshafee, Abdel Razzaq; Gabashneh, Sadeq; MSF-OCA (2018-07)
      2. OBJECTIVES 2.1. PRIMARY OBJECTIVES • To determine the level of access to health care services for Syrian refugees living out-of-camp in Irbid governorate, Jordan. 2.2. SECONDARY OBJECTIVES • To describe the socio-demographic characteristics of the surveyed population including age, gender, disabilities, time living in Jordan, living conditions, and legal status • To describe the economic situation of the surveyed households with regards to income & income sources, dependency on humanitarian assistance, household expenditures and direct and indirect expenditures on health • To characterize health care utilization of non-camp Syrian refugees including frequency & type of services used as well as the main reasons for requiring medical care • To estimate coverage with the most crucial health services such as vaccination coverage of under 5-year-old children, coverage with services for non-communicable diseases and maternal health coverage. • To estimate the coverage of MSF services including specifically NCD care as well as ANC and child health care • To estimate health service needs by estimating the household- prevalence of NCDs as well as the birth rate. • To identify barriers to accessing general-, as well as specialized health care services with regards to economic constraints, barriers resulting from knowledge gaps as well as limitations in accessibility and/or acceptability of existing services. • To identify risk factors for not accessing general and specialized health services as needed. • To estimate retrospectively the crude mortality rate (CMR) and specific mortality rates for the total population and for children under five years of age (U5MR).
    • The Impact of a Tick-Sheet in Improving Interpretation Accuracy of Chest Radiographs by Non-Specialists in an HIV positive cohort

      Kosack, Cara; Mesic, Anita; Spijker, Saskia; Bonnet, Maryline; Joekes, Elizabeth; MSF-OCA (2018-07)
      Study objective 3.1 Primary objective To determine if the application of a tick-sheet after four hour training on its use and on CXR interpretation, improves the interpretation accuracy of CXRs for active TB, by nonspecialists, in an HIV-positive cohort. 3.2 Secondary objective To determine whether the application of a tick-sheet reduces the inter-reader variability of CXR interpretation in a group of non-specialists by comparing the inter-reader agreement before and after intervention.
    • The Impact of digital X-ray with Teleradiology on Case Management in Mweso, Democratic Republic of Congo

      Kosack, Cara; Halton, Jarred; Greig, Jane; Shanks, Leslie; Spijker, Saskia; MSF-OCA (2018-07)
      Study objectives 3.1 Primary objective To demonstrate the extent of change in patient management through the availability of digital X-ray with teleradiology consultation. 3.2 Secondary objectives a) To demonstrate the extent of change in patient diagnosis through the availability of digital X-ray with teleradiology consultation. b) To demonstrate the extent of change in patient diagnosis and management in the subgroup of patients with chest pathologies through the availability of digital X-ray with teleradiology consultation. c) To estimate if the extent of change in diagnosis and management is different in patients < 5 years of age versus ≥5 years of age.
    • Improving utilisation of services for sexual and gender-based violence (SGBV): knowledge, attitudes, practices and perceptions (KAP) in Jahangipuri, Delhi India protocol

      Himanshu, M; Sharmin, Sabrina; Renjhen, Prachi; Saheb, Baba; Gupta, Vinita; MSF-OCA (2018-07)
      2 Research question and objectives 2.1 Research question To identify factors that could improve SGBV service utilisation and acceptance amongst MSF’s catchment population in Delhi, India 2.2 Primary objective To understand how to improve utilization of SGBV services for the population in MSF catchment area Delhi, India 2.3 Specific objectives 1. To understand community knowledge related to SGBV, including its consequences, treatment and clinical services 2. To understand attitudes towards health aspects of SGBV 3. To explore practices related to SGBV care seeking pathways, including barriers and enablers affecting service access and uptake 4. To understand which strategies/activities people consider would be effective in improving access and uptake of clinical services by survivors of SGBV
    • Innovations in research ethics governance in humanitarian settings

      Schopper, Doris; Dawson, Angus; Upshur, Ross; Ahmad, Aasim; Jesani, Amar; Ravinetto, Raffaella; Segelid, Michael J; Sheel, Sunita; Singh, Jerome (BioMed Central, 2015-02-26)
    • Knowledge, Attitudes and Practice (KAP) survey of Long-Lasting Insecticide-treated bedNets (LLITNs) in the refugee camps of Kule, Tierkidi and Nguenyyiel, in Gambela, Ethiopia, MSF-OCA catchment area.

      Doyle, Kate; Isidro Carrion Martin, Antonio; Piening, Turid; Ramirez, Angela; Fesselet, Jeff; Loonen, Jeanine; Rao, V Bhargavi; Brechard, Raphael; MSF-OCA (2018-07)
      Ethiopia is a land locked country in east Africa, known for its deep culture and history as well as its struggle with disease outbreaks, drought, malnutrition and major refugee inflex’s. According to UNDP Ethiopia is ranked at 174 in the human development index. Life expectancy at birth is 64.6 years, infant mortality rate is 41.4 (per 1,000 live births), under 5 mortality rate is 59.2 (per 1,000 live births) and deaths from Malaria are 106 (per 100, 000 people). Historically, Gambella region and Itang woreda area are places of ethnic tension between original Agnuak population, Nuers who have arrived in earlier refugee movements 20+ years back, and new Nuer refugees, and Highlanders. All incomers to the area are not refugees, and movement to/from both sides of the South Sudanese border is frequent. Tribal clashes and single incidents take place often; of late the bigger fighting has been less frequent. In Gambella region there are currently 6 camps and 5 reception centers. MSF activities are focused across 3 camps (Kule, Tierkidi and Nguenyyiel) and 1 reception center (Pamdong). While the current refuges crises has been present since early 2014, over the last 18 months more than 130,000 new arrivals have entered Ethiopia, leading to the creation of the latest camp, Nguenyyiel. As of 31st March 2018, official UNHCR data indicates a total South Sudanese population in the region to be 419,259, which now exceeds the local/host population. Key demographics include; 55% of population to be female; 64% to be under 18 years of age; 88% to be women and children. Within this total there are 3,076 unaccompanied minors (0.73%) and 23,238 are separated children (5.5%). It is assumed that also in 2018 the number of unregistered refugees will massively increase due to unwillingness for relocation to other regions creating the need for further extensions or new camps. As all people staying in Gambella camps are not registered with UNHCR, many who seek help with MSF are not officially entitled to it. ARRA health Centres in Tierkidi and Nguenyyiel refuse to treat those without ration card/registration. In case of need of further referral to Gambella hospital, MSF are forced to compromise with the treatment, as those patients are not granted a permit. Across the region, but specifically in the camps served by MSF, we see very high case load of malaria, with major spikes during the rainy season. In 2017, across Kule and Tierkidi camps, MSF treated more than 70,000 people for malaria. Prevention efforts in the camps have been very weak, with limited bed net distribution (last one in 2014) and poorly planned/executed IRS campaigns (Oct 2017—late rain season). MSF will now engage to take on a more active role in prevention and treatment mechanisms including mass bed net distribution, IRS campaigns, use of primaquine (decreased transmission); improved follow up of cases requiring re-treatment as well as participating in a study with the Ethiopian Public health institute looking into the presence of HRP2 gene deletion. PRIMARY OBJECTIVES  To estimate the Long-Lasting Insecticide-Treated bedNets (LLITN) coverage ratio for the total population in the MSF catchment area SECONDARY OBJECTIVES  To describe the population surveyed by sex and age  To measure the LLITN coverage ratio for children under five years of age and pregnant women  To estimate indoor residual spraying (IRS) coverage ratio for the total population in the MSF catchment area  To assess malaria knowledge, attitude and practices in the population including recognition of symptoms, and how to prevent malaria with special focus on LLITN.  To assess knowledge, attitude and practices about malaria treatment.
    • Long term follow up of Noma patients after surgical, nutritional and mental health interventions at the Noma Children’s Hospital in northwest Nigeria, 2018

      Farley, Elise; Lenglet, Annick; Bil, Karla; Amirtharajah, Mohana; Fotso, Adolphe; Oluyide, Bukola; Jiya, N M; Adetunji, Adeniyi Semiyu; Usman, Taiwo; Winters, Ryan; et al. (2018-06)
      Noma is a little understood, rapidly progressing gangrenous infection of the oral cavity, associated with a reported 90% mortality rate [1]. Noma mostly affects children under the age of five, and those who survive have severe facial disfigurements (2) and multiple physical impairments such as difficulty eating, seeing and breathing. Noma can also cause stigmatization due to these impairments [2]. The incidence of Noma is estimated to be 6.4 per 1000 children [3], and the World Health Organisation estimate that 140 000 children contract Noma each year [4]. Noma is thought to be most prevalent along the Noma belt which stretches from Senegal to Ethiopia [2], however Noma cases have recently been reported in the United Kingdom[5], United States [6], Afghanistan [7], South Korea [8] and Laos [9]. Little is known about Noma as the majority of cases live in underserved areas, difficult to reach locations, the mortality rate is high and the disease often goes undiagnosed. Noma starts as an inflammation of the gums, similar to a mouth ulcer, which then leads to the rapid destruction (one week [4]) of the jaw, lip, cheek, nose and sometimes eye [10]. During the first active stages of the disease, antibiotic treatment and wound dressing are effective forms of care, once Noma becomes inactive, patients can survive into adulthood but require extensive reconstructive surgery. The pathogenic cause of Noma is unknown [4]. Noma typifies the complex interactions between extreme poverty, severe malnutrition, poor oral hygiene practices, limited access to high quality health care [7] and co-morbidities with infections such as measles [1,2,7,11–18], malignancies, particularly leukaemia [4,11–13,16,17,19], Human Immunodeficiency Virus (HIV) [2,4–7,9,13,17–20] and Crohn’s Disease [8]. Long term outcomes of Noma treatment are difficult to ascertain due to inconsistent follow up because of the remote locations of home villages of patients and difficulties with access to health care assessments. A 2010 paper on the outcome of trismus release in Noma patients in northwest Nigeria (patients from the Noma Children’s Hospital), showed that the long term results of trismus release were poor with only 39% of patients showing improvement in mouth opening [21]. This shows a need to carefully monitor outcomes to try to ascertain what factors favour positive outcomes so that these can be the focus of treatment plans. Médecins Sans Frontières (MSF) runs programs at the Noma Children’s Hospital (NCH) in Sokoto, northern Nigeria, and currently assists with surgical interventions for the patients who have survived and sought care at the hospital. Community outreach, active case finding, follow up assessments and prevention programming are also supported by MSF. These projects place MSF in a unique position to study Noma, and to add to the scant body of knowledge around the disease. In 2017, MSF conducted a comprehensive descriptive study of the Noma patients treated since 2015 in the project in addition to a case control study for Noma patients. Results from these studies indicated that current routine data collection was sub-optimal. In order to be able to track clinical outcomes of Noma patients, more robust data collection and longer term follow up is needed. The current study aims to address one of the highlighted gaps from the 2017 case review which is the absence of comprehensive information on surgeries performed (including techniques) and clinical outcomes of Noma patients after surgery (in terms of surgical, anaesthesia-related and post-surgical complications, including infections) and outcome information after discharge from the hospital. Additionally, it will aim to establish better ways in which to ensure that current medical data on previous medical and vaccination history of each individual Noma patient are being accurately collected and analysed. Only by implementing a systematic and controlled method of data collection in conjunction with systematic follow up will our medical teams learn from current interventions and be able to use these recommendations for improved clinical management.
    • Long term follow up of Noma patients after surgical, nutritional and mental health interventions at the Noma Children’s Hospital in northwest Nigeria, 2018

      Farley, Elise Principal Investigator; MSF OCA (2018-06-13)
      Background Noma is a little understood, rapidly progressing gangrenous infection of the oral cavity, associated with a reported 90% mortality rate [1]. Noma mostly affects children under the age of five, and those who survive have severe facial disfigurements (2) and multiple physical impairments such as difficulty eating, seeing and breathing. Noma can also cause stigmatization due to these impairments [2]. The incidence of Noma is estimated to be 6.4 per 1000 children [3], and the World Health Organisation estimate that 140 000 children contract Noma each year [4]. Noma is thought to be most prevalent along the Noma belt which stretches from Senegal to Ethiopia [2], however Noma cases have recently been reported in the United Kingdom[5], United States [6], Afghanistan [7], South Korea [8] and Laos [9]. Little is known about Noma as the majority of cases live in underserved areas, difficult to reach locations, the mortality rate is high and the disease often goes undiagnosed. Noma starts as an inflammation of the gums, similar to a mouth ulcer, which then leads to the rapid destruction (one week [4]) of the jaw, lip, cheek, nose and sometimes eye [10]. During the first active stages of the disease, antibiotic treatment and wound dressing are effective forms of care, once Noma becomes inactive, patients can survive into adulthood but require extensive reconstructive surgery. The pathogenic cause of Noma is unknown [4]. Noma typifies the complex interactions between extreme poverty, severe malnutrition, poor oral hygiene practices, limited access to high quality health care [7] and co-morbidities with infections such as measles [1,2,7,11–18], malignancies, particularly leukaemia [4,11–13,16,17,19], Human Immunodeficiency Virus (HIV) [2,4–7,9,13,17–20] and Crohn’s Disease [8]. Long term outcomes of Noma treatment are difficult to ascertain due to inconsistent follow up because of the remote locations of home villages of patients and difficulties with access to health care assessments. A 2010 paper on the outcome of trismus release in Noma patients in northwest Nigeria (patients from the Noma Children’s Hospital), showed that the long term results of trismus release were poor with only 39% of patients showing improvement in mouth opening [21]. This shows a need to carefully monitor outcomes to try to ascertain what factors favour positive outcomes so that these can be the focus of treatment plans. Médecins Sans Frontières (MSF) runs programs at the Noma Children’s Hospital (NCH) in Sokoto, northern Nigeria, and currently assists with surgical interventions for the patients who have survived and sought care at the hospital. Community outreach, active case finding, follow up assessments and prevention programming are also supported by MSF. These projects place MSF in a unique position to study Noma, and to add to the scant body of knowledge around the disease. In 2017, MSF conducted a comprehensive descriptive study of the Noma patients treated since 2015 in the project in addition to a case control study for Noma patients. Results from these studies indicated that current routine data collection was sub-optimal. In order to be able to track clinical outcomes of Noma patients, more robust data collection and longer term follow up is needed. The current study aims to address one of the highlighted gaps from the 2017 case review which is the absence of comprehensive information on surgeries performed (including techniques) and clinical outcomes of Noma patients after surgery (in terms of surgical, anaesthesia-related and post-surgical complications, including infections) and outcome information after discharge from the hospital. Additionally, it will aim to establish better ways in which to ensure that current medical data on previous medical and vaccination history of each individual Noma patient are being accurately collected and analysed. Only by implementing a systematic and controlled method of data collection in conjunction with systematic follow up will our medical teams learn from current interventions and be able to use these recommendations for improved clinical management.
    • Longitudinal cohort to evaluate Hepatitis C treatment effectiveness in HIV co-infected patients: Manipur, India

      Himanshu, M; Singh, Karam Romeo; Shougrakpam, Jeetesh; MSF-OCA (2018-07)
      4. OBJECTIVES Primary objective The primary objective of this study is to assess the effectiveness of HCV curative treatments in patients with chronic hepatitis C (CHC), co-infected with HIV in Manipur, India. Secondary objectives a. To describe the demographic, clinical and biological characteristics of patients with chronic hepatitis C and HIV co-infection b. To assess the effectiveness of HCV curative strategies in patients with chronic HCV, co-infected with HIV stratified by regimen and by site c. To identify risk factors associated with differing virological responses d. To assess the safety of HCV treatment e. To monitor the safety of HCV treatment in HIV co-infected patients f. To document the clinical and biological tolerance of the HCV treatment g. To assess the feasibility of HCV treatment h. To assess comparative performance of elastography (Fibroscan®) and APRI (AST to Platelet Ration Index), to evaluate liver fibrosis among HIV/HCV co-infected individuals i. To describe causes of non-eligibility for treatment j. To describe the clinical and biological evolution of co-infected patients, not eligible for HCV treatment k. To assess treatment adherence
    • Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Final Survey) 1613C

      Lenglet, Annick; Vernier, Larissa; Monge, Susana; White, Kate; Sang, Sibylle; MSF-OCA (2018-07)
      3 OBJECTIVES 3.1 PRIMARY OBJECTIVES To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district. 3.2 SECONDARY OBJECTIVES - To describe the population in terms of age breakdown, sex, household composition etc. - To estimate overall mortality rate and under 5 mortality rate - To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities; - To estimate the coverage of insecticide treated bednets in the community; - To estimate the coverage of soap and hygiene practices in the community - To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz.
    • Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Mid Term Survey).

      Lenglet, Annick; Monge, Susana; Ndumbi, Patricia; Nyarwangu, Justin; Hamdan, Musa; Cramond, Vanessa; Sang, Sibylle; MSF-OCA (2018-07)
      3 OBJECTIVES 3.1 PRIMARY OBJECTIVES To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district. 3.2 SECONDARY OBJECTIVES - To describe the population in terms of age breakdown, sex, household composition etc. - To estimate overall mortality rate and under 5 mortality rate - To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities; - To estimate the coverage of insecticide treated bednets in the community; - To estimate the coverage of soap and hygiene practices in the community - To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz.
    • Maternal and child health care seeking behaviour: a household survey and interview study in an urban and rural area of Sierra Leone, 2016

      Elston, James; Snag, Sibylle; Kazungu, Donald Sonne; Jimissa, A; Caleo, Grazia; Danis, Kostas; Lokuge, Kamalini; Black, Benjamin; Gray, Nell; MSF-OCA (2018-07)
      To describe health seeking behaviour during pregnancy, for childbirth and in children under the age of five years, and to identify barriers to accessing and receiving healthcare services at the time of the study and since the start of the Ebola outbreak in an urban and rural area of Tonkolili District. 2.2 PRIMARY OBJECTIVES 1. To estimate utilisation of health facilities by women for childbirth in Magburaka town and Yoni chiefdom since the start of the Ebola outbreak ; 2. To estimate utilisation of healthcare services by children aged <5 years in Magburaka town and Yoni chiefdom during their most recent febrile illness within the three month period preceding the day of the survey. 3. To identify and describe factors influencing utilisation of health services and delays in seeking and receiving adequate healthcare during pregnancy and for childbirth 4. To identify and describe factors influencing utilisation of health services and delays in seeking and receiving adequate healthcare for febrile illness in children aged <5 years
    • Mental health literacy of internally displaced Iraqi young people and their parents in Iraq: paving the way for mental health education and promotion in vulnerable communities.

      Hitchman, Eleanor; Slewa-Younan, Shameran; Lunenborg, Norbert; Bil, Karla; Lenglet, Annick; Jorm, Anthony F.; MSF-OCA (2018-07)
      4. Objectives 4.1 Primary objectives To determine levels of MHL relating to trauma related mental health disorders, namely posttraumatic stress disorder (PTSD) and depression among the displaced Iraqi young people in northern Iraq (see study population). 4.2 Specific objectives 1. To estimate MHL relating to PTSD (and Depression) in a group of displaced Iraqi young people (13-17 years old) and the parents of children (8-12 years old) pertaining to: a. Problem recognition (including “self-recognition”) b. Beliefs about the severity of the problem described and its prevalence in the target population c. Beliefs about causes and risk factors d. Beliefs about how best to support someone with PTSD/depression e. Beliefs about the helpfulness of specific treatments and treatment providers f. Beliefs about likely outcome with and without treatment g. Beliefs about possible barriers to treatment h. Stigma and perceived discrimination towards someone with PTSD/depression 2. To determine associations between specific aspects of MHL as outlined above, and individuals’ demographic characteristics (age, gender, religion, ethnicity, lengthen of displacement etc.) and symptom levels. 3. To estimate the prevalence of mental health distress (major depression, anxiety disorders or suicidality ) using the Self Reporting Questionnaire (SRQ-20) in care takers of children 8-12 years old; 4. To estimate the prevalence of constructs of intrusion, avoidance and arousal in children 8-17 years of age in the study population; 5. To estimate the prevalence of self-reported depression in children 8-17 years old. The categories specified in objective 1 above were chosen because they were considered to be the aspects of MHL most likely to be of interest in informing the determinants of mental health in the proposed population. Objective 2 which seeks to examine the associations between specific aspects of MHL and individuals’ demographic characteristics and symptoms levels is important because associations of this kind can indicate specific targets for health promotion programs.
    • Mental health literacy of internally displaced Syrian young people and their parents in Syria: paving the way for mental health education and promotion in vulnerable communities.

      Hitchman, Eleanor; Slewa-Younan, Shameran; Cramond, Vanessa; White, Kate; Carrion-Martin, Isidro; Jorm, Anthony F.; MSF-OCA (2018-07)
      4. Objectives 4.1 Primary objective To determine levels of MHL relating to trauma related mental health disorders, namely posttraumatic stress disorder (PTSD) and depression among the displaced Syrian young people in northern Syria (see study population) . 4.2 Specific objectives 1. To estimate MHL relating to PTSD (and Depression) in a group of displaced Syrian young people (13-17 years old) and the parents of children (age 8-12 years old) pertaining to: a. Problem recognition (including “self-recognition”) b. Beliefs about the severity of the problem described and its prevalence in the target population c. Beliefs about causes and risk factors d. Beliefs about how best to support someone with PTSD/depression e. Beliefs about the helpfulness of specific treatments and treatment providers f. Beliefs about likely outcome with and without treatment g. Beliefs about possible barriers to treatment h. Stigma and perceived discrimination towards someone with PTSD/depression i. 2. To determine associations between specific aspects of MHL as outlined above, and individuals’ demographic characteristics (age, gender, religion, ethnicity, lengthen of displacement etc.) and symptom levels. 3. To estimate the prevalence of mental health distress (major depression, anxiety disorders or suicidality ) using the Self Reporting Questionnaire (SRQ-20) in care takers of children 8-12 years old; 4. To estimate the prevalence of constructs of intrusion, avoidance and arousal in children 8-17 years of age in the study population; 5. To estimate the prevalence of self-reported depression in children 8-17 years old. The categories specified in objective 1 above were chosen because they were considered to be the aspects of MHL most likely to be of interest in informing the determinants of mental health and quality of life in the proposed population. Objective 2 which seeks to examine the associations between specific aspects of MHL and individuals’ demographic characteristics and symptoms levels is important because associations of this kind can indicate specific targets for health promotion programs.
    • A Médecins Sans Frontières ethics framework for humanitarian innovation plus case studies to guide its use

      Sheather, Julian; Jobanputra, Kiran; Schopper, Doris; Pringle, John; Venis, Sarah; Wong, Sidney; Vincent-Smith, Robin; British Medical Association, Ethics Department, BMA House, London, UK; Médecins Sans Frontières (MSF), Manson Unit, London, UK; Medical Faculty, University of Geneva, Geneva, Switzerland; Centre for Education and Research in Humanitarian Action (CERAH), Geneva, Switzerland; McGill University, Montreal, Canada; MSF, Amsterdam, The Netherlands; MSF, Brussels, Belgium (2016-07)
      Case studies to help guide use of the Médecins Sans Frontières ethics framework for humanitarian innovation
    • Morbidity, healthcare needs and barriers to access medical care amongst local and displaced populations in west Dar’a and Quneitra, Southern Syria.

      Homan, Tobias; Shoaib, Muhammad; de Rosa, Allan; Alfadel, Imad Aldin; Stein, Susan; Khalaileh, Fadi; Al-Khalouf, Nahed; Bil, Karla; MSF-OCA (2018-07)
      Objectives 2.1 Primary objective To determine the health care needs for local population and IDP’s in west Dar’a and Quneitra by estimating the prevalence of underlying morbidities, vaccination coverage and identifying barriers to access to health care, in order to obtain a baseline that can guide MSF and actor response. 2.2 Secondary objectives The relevance of subjects for the (secondary) objective(s) has been informed by insights from reports of, and explorative meetings with MSF and medical NGOs active in southern Syria (section 3.2.3). Of the secondary objectives identified, similar objectives are reflected in MSF-ERB approved protocols for surveys conducted in the region. We formulated the objectives (and related indicators on page 15) as much as possible on basis of these approved secondary objectives . I. To describe the socio-demographic characteristics of the surveyed population including age, gender and household characteristics. II. To estimate the prevalence of self-reported morbidities in previous two weeks, an estimate of the prevalence of non-communicable diseases, and the main reasons for requiring medical care. III. To estimate the vaccination coverage for key vaccine preventable diseases in children aged 6-59 months. IV. To characterise health care utilisation, the degree of access to healthcare for common morbidities in the population (health seeking behviour) and determine the most common barriers to access to health care. V. To estimate the global acute malnutrition [GAM] rate of in children aged 6-59 months. VI. To estimate the prevalence of conflict-related trauma experienced during the recall period. VII. To what extent maternal and reproductive health services are utilized by assessed crisis-affected women of 15-49 years of age in this area. VIII. To estimate the retrospective mortality and cause of mortality, over the past 6 months (since Ramadan 2017). IX. To better understand the configuration of the health system following the crisis, the characteristics of care-seeking and the quality of the services.
    • MSF Data sharing log updated 9th March 2015

      Amrit Dulkoan; MSF London (2015-03-09)