INITIAL RAPID ASSESSMENT (IRA) TOOL: FIELD ASSESSMENT FORM

United Nations Inter-Agency Standing Committee (UN IASC) Health Cluster Nutrition Cluster WASH Cluster INITIAL RAPID ASSESSMENT (IRA) TOOL: FIELD ASSESSMENT FORM How to use this form The IRA field assessment form is divided into 7 sections. Sections 1 and 2 cover site identification and demographic data. Sections 3 to 7 covers specific sectors of concern (health, nutrition, shelter, etc.). At the end of the assessment visit, one form should be filled out per site, reflecting the joint findings of the assessment team for the site. Assessment team members should keep records of the data they gather through interviews, observation, group discussions etc. as they proceed, either by writing separate notes or by writing in the boxes on their individual copies of the form. The summary section on pages 1 and 2 should be filled in by the field assessment team, highlighting the main problems identified and recommendations for action, based on the data collected using the tool. These pages can also be filled in directly by teams or individuals who have very limited time at a particular location and so may not have the opportunity to address the detailed questions on the form. The site is defined here as the place where an affected population is located at the time of the assessment visit (for example a village, a camp of displaced people, a group of people whose homes have been destroyed etc.). Often there will be several sites in an affected area. Where there is a very large population located in one settlement it may be necessary to treat distinct parts of the settlement as individual sites. Before starting fieldwork, the assessment team should decide on a strategy for data collection, including who will collect data to fill in which sections of the form, and how data will be collected and recorded. The table on Page 3 advises appropriate methodologies for gathering data to complete specific sections of the form. The assessment team can use the same table to note the methodologies actually used at a particular site. Any important issues encountered at the site that are not dealt with by the questions in the form, as well as any apparent contradictions in data or unexpected data, should be noted in the boxes at the end of each section. Completed IRA Tool assessment forms should be returned to country clusters for analysis. It is most important that data is recorded legibly and clearly so that errors are not made when transferring and analyzing data. Prepared jointly by: IASC Health Cluster IASC Nutrition Cluster IASC WASH Cluster 1 January 2008 1

TABLE OF CONTENTS Data Collection Strategy...... 17 Summary.. 18 Section 1 Identification Information. 20 Section 2 Population Description.. 21 Section 3 Shelter and Essential Non-Food Items.... 23 Section 4 Water Supply, Sanitation and Hygiene... 26 Section 5 Nutrition and Food Security.. 30 Section 6 Health Risks and Health Status.... 34 Section 7 Health Facility Assessment 36 INITIAL RAPID ASSESSMENT (IRA) FORM 2

IRA DATA COLLECTION STRATEGY Recommended data collection strategy: Section of IRA Form 2. Population description 3.2 Access to shelter and shelter quality 3.3 Access to essential non-food items 4.2 Local capacity in WASH 4.3.1- Water supply 4.3.8 4.3.9- Water consumption and collection 4.3.10 time 4.5.1 Defecation practices 4.5.2 Number of toilets 4.5.3- Environmental sanitation 4.5.5 4.7 Access to hygiene items 4.9 Population priorities for WASH 5.3 Food aid 5.4 Food consumption 5.5 Observation of household food stocks 5.6 Food access 5.7 Nutritional status: data and reports 5.8 5.9 Population priorities in nutrition and food security 6.2 Nearest health facility 6.3 Health profile 7. Health facility assessment Local secondary data Key informant interviews Group discussions Householdlevel interviews Householdlevel observation Observation: transect walks, markets, water points IRA FORM DATA COLLECTION STRATEGY 3

IRA SUMMARY Name and locality of site assessed: GPS coordinates and P-code: Date(s) of field assessment: / / - / / Population at site (# people): Name and organisation of team leader: Principal contact(s) at the site: Summary of the crisis: overall judgment of humanitarian situation short-term outlook (whether the crisis is worsening or becoming less serious) factors that could worsen humanitarian conditions or impede relief operations (bad weather, insecurity etc.) population groups that are inaccessible (and if so, why) Other problems and priorities identified by the affected population: KEY FOR RANKING SEVERITY OF NEED (NEXT PAGE) Red Severe situation: urgent intervention required Orange Situation of concern, or lack of data/unreliable data: further assessment and/or surveillance required Green Relatively normal situation or local population able to cope with crisis; no further action required IRA FORM SUMMARY 4

Ranking of severity of need Problems identified Recommendations Red Population and demographics Orange Green Sites and shelter Essential non-food items Water supply Red Orange Green Red Orange Green Red Orange Green Sanitation Red Orange Green Hygiene Red Orange Green Food security Red Orange Green Nutrition (including infant & young child feeding) Health risks and health status Health facilities Red Orange Green Red Orange Green Red Orange Green Other (specify) (e.g. violence, missing persons) Red Orange Green IRA FORM SUMMARY 5

SECTION 1 IDENTIFICATION INFORMATION 1.1 PLACE AND DATE: 1.1.1 Name and location of site being assessed. (Note administrative/district boundaries, and which government authorities should be involved. Note estimated size of site and attach map if possible.) 1.1.2 GPS Coordinates and satellite system: P-Code if available 1.1.3 Date(s) of the visit: 1.1.4 Hours of the visit: 1.1.4 Main contact at this site: 1.2 ASSESSMENT TEAM: Name Institution Title / position Profession/ qualifications IRA FORM SECTION 1: IDENTIFICATION INFORMATION 6

SECTION 2 POPULATION DESCRIPTION 2.1 RESOURCE PERSONS AND OTHER INFORMATION SOURCES: 2.2 REGISTRATION: 2.2.1 Are the crisis affected people being registered, or have they been registered (Check one)? Yes No 2.2.2 If yes, which by which institution(s)? 2.3 MOVEMENT TO AND FROM THIS SITE: 2.3.1 Number of people arriving (Note time period): Number of people leaving (Note time period): 2.3.2 Number of additional people expected (Note time period): 2.3.3 How people are moving (Check the two most common): As individuals By household By village / neighbourhood Other (specify) 2.3.4 Distinct social or ethnic groups found within the affected and surrounding populations: 2.3.5 Types of leaders moving or residing with the affected population (Check all that apply): Government (e.g. local) Religious leaders Traditional leaders Other (specify) 2.4 SIZE OF CRISIS-AFFECTED POPULATION: 2.4.1 Total estimated current population of site: # People: 2.4.2 If the estimate is based on the number of # Households 1 : People per household: households and average household size: 2.4.3 Estimated % who are not displaced: % 2.4.4 Estimated % who are internally displaced: % 2.4.5 Estimated % who are refugees, stateless, or other nationalities: % 2.4.6 Source of these population data (several responses possible) Estimate by local authorities Estimate by affected population Census (specify the date of the census) Registration Estimated from # households and # people per household Other (specify) 1 The household is defined here as a group of people, usually of the same family, who share livelihoods and vital activities and resources. IRA FORM SECTION 2: POPULATION DESCRIPTION 7

2.5 VULNERABLE GROUPS: 2.5.1 If there is information suggesting that one or more groups is more or fewer than expected (e.g. women or girl children are underrepresented for some reason), explain here: 2.5.2 Estimated number of unaccompanied minors: # 2.5.3 Main reason(s) for minors being unaccompanied: Death of parents Separation from parents during flight Evacuation of minors Other 2.5.4 Estimated number of infants without mothers (or other longer term primary caretakers): 2.5.5 Information on the situation of these infants: # 2.6 DISPLACED POPULATION (ONLY COMPLETE THIS SECTION IF PART OR ALL OF THE AFFECTED POPULATION IS MADE UP OF INTERNALLY OR INTERNATIONALLY DISPLACED PEOPLE): 2.6.1 Place of origin of the displaced people (If different displaced groups are in this site, indicate the origins separately for each.) 2.6.2 Main factors preventing the return home of the displaced (If different displaced groups are in this site, answer separately for each.) 2.6.3 Organisation of the settlement (Check all that apply. If different displaced groups are in this site, answer separately for each.) Camp in rural area Staying with host families in a rural area Camp in urban area Staying with hot families in an urban area Collective settlement in large buildings Other (specify) 2.6.4 Relations between the displaced and the host community? (Check all that apply.) Host community willing to assist Tensions Other (specify) 2.7 PEOPLE DEAD, MISSING OR INJURED DUE TO THE CRISIS 2.7.1 Dead: People 2.7.2 Missing: People 2.7.3 Injured: People 2.8 ECONOMIC ACTIVITY 2.8.1 Types of economic activity ongoing since the crisis (trading, industries, crafts, agriculture, services etc.) 2.8.2 Extent to which people can access essential goods and services (e.g. food, shelter, health care, hygiene items) using resources from savings and/or production and economic activities? IRA FORM SECTION 2: POPULATION DESCRIPTION 8

SECTION 3 SHELTER AND ESSENTIAL NON-FOOD ITEMS 3.1 RESOURCE PERSONS AND OTHER INFORMATION SOURCES: 3.2 ACCESS TO AND QUALITY OF SHELTER: 3.2.1 Proportion of people currently living in each type of accommodation below: (Where the displaced are staying with host families, count all the people in the accommodation.) Type of accommodation Population with each type of accommodation Average surface area of each house/shelter m 3 Average number of people per house/shelter Typical house people Temporary family shelter people Collective shelter people Without shelter people Total people 3.2.2 For houses and temporary family shelters housing people affected by the crisis, note the following: Protection from cold, heat, wind, rain, snow etc. Privacy Personal security and security of belongings Protection from fire Covered space for essential household activities Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Somewhat poor Somewhat poor Somewhat poor Somewhat poor Somewhat poor 3.2.3 Note the types of locally-sourced materials being used to build or adapt shelters: Metal Timber Canvas / plastic sheets Local materials Other (specify) IRA FORM SECTION 3: SHELTER AND ESSENTIAL NON-FOOD ITEMS 9

3.2.4 A For collective shelters housing people affected by the crisis, note the following points (one table per collective shelter): Identification / name of shelter Number of people sleeping in the shelter Protection from cold, heat, wind, rain, snow etc. Privacy Personal security and security of belongings Protection from fire Covered space for essential household activities Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Somewhat poor Somewhat poor Somewhat poor Somewhat poor Somewhat poor Type of building Number of floors 3.2.4 B For collective shelters housing people affected by the crisis, note the following points (one table per collective shelter): Identification / name of shelter Number of people sleeping in the shelter Protection from cold, heat, wind, rain, snow etc. Privacy Personal security and security of belongings Protection from fire Covered space for essential household activities Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Very poor/not at all Acceptable Somewhat poor Somewhat poor Somewhat poor Somewhat poor Somewhat poor 3.3 OTHER OBSERVATIONS CONCERNING SHELTER AT THIS SITE Type of building Number of floors IRA FORM SECTION 3: SHELTER AND ESSENTIAL NON-FOOD ITEMS 10

3.4 ACCESS TO ESSENTIAL NON-FOOD ITEMS (NFIS): 3.4.1 Proportion of households with sufficient clothing for protection from the cold, heat, rain, etc.: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.4.2 Proportion of households with sufficient blankets and bedding for protection from the cold: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.4.3 Type of fuel used for cooking: Is there enough cooking fuel? YES NO If no, explain why: 3.4.4 Proportion of households with sufficient cooking utensils: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.4.5 Proportion of households with plastic sheeting for temporary shelter: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.4.6 Proportion of households with tools for construction of shelter: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.4.7 Proportion of households with the means to provide artificial lighting: Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 3.5 OTHER OBSERVATIONS CONCERNING ACCESS TO ESSENTIAL NON-FOOD ITEMS AT THIS SITE IRA FORM SECTION 3: SHELTER AND ESSENTIAL NON-FOOD ITEMS 11

SECTION 4 WATER SUPPLY, SANITATION AND HYGIENE 4.1 RESOURCE PERSONS AND OTHER SOURCES OF INFORMATION : 4.2 EXISTING CAPACITIES AND ACTIVITIES Organisation or person(s) Normal / current activities responsible 4.3.1 Water supply Limitations to capacity or performance (lack of staff, materials and equipment, funds, access etc.) 4.3.2 Sanitation 4.3.3 Hygiene 4.3 WATER SUPPLY Water resources : note in this table data concerning sources of water available for the population at the site 4.3.1 Number of water sources of each type 4.3.2 Water source most used for human consumption et this site 4.3.3 Water source most used for animal consumption et this site 4.3.4 Any water sources produce dirty-looking water 4.3.5 Any sources for which it is likely that the quantity of water available will fall in the near future Surface water (specify if a lake, a river or other) Borehole or well with functioning handpump Borehole or well with functioning motor pump Protected open well Unprotected open well Unprotected spring Protected spring Traditional water sellers (specify the source) Other (specify) Borehole or well with non-functioning handpump Borehole or well with non-functioning motor pump IRA FORM SECTION 4: WATER SUPPLY, SANITATION AND HYGIENE 12

4.3.6 If possible, estimate the total quantity of water (in m 3 per day) available at the site m 3 4.3.7 For any water sources for which it is likely that the quantity of water available will fall in the near future, explain why: 4.3.8 Where applicable, note any water supplies used for drinking and cooking that are treated at any point in the chain between the water source and consumption. Source(s) involved Treatment process(es) Effectiveness of the treatment process(es) None, not functioning or destroyed Functioning but not reliable Functioning reliably None, not functioning or destroyed Functioning but not reliable Functioning reliably None, not functioning or destroyed Functioning but not reliable Functioning reliably 4.3.9 Quantity of water used per household per day for all uses Drinking, cooking and hygiene >75 litres 51-75 litres 26-50 litres Animals Washing clothes Other (specify) litres litres litres <25 litres 4.3.10 Note the time, in minutes that it takes on average to collect all the water required for a household for one day (including the journey time, waiting time at the water point and time to fill the water containers) If several trips are required per day, count the total time required for all the trips. >120 min 61-120 min 30-60 min <30 min 4.3.11 If this is a pastoral community, note the current source of water for livestock Same source as for human consumption Same source as for human consumption plus another source Only from a separate source to the one used for human consumption 4.4 Additional comments concerning water supply at this site IRA FORM SECTION 4: WATER SUPPLY, SANITATION AND HYGIENE 13

4.5 SANITATION: 4.5.1 Number of people, out of 10, on average, currently using each of the places listed below to go to defecate In the open, not in a defined and managed defecation area In a defined and managed defecation area In public toilets (pit latrines, pour-flush latrines, flushing toilets etc.) In family toilets and shared family toilets (pit latrines, pour-flush latrines, flushing toilets etc.) Check that this column adds up to 10 4.5.2 Average number of users per functioning toilet > 100 51 100 21-50 20 4.5.3 Presence of human faeces on the ground on and around the site substantial presence less than 10 m from shelters substantial presence less than 10 m from water sources substantial presence, generally more than 10 m from shelters substantial presence, generally more than 10 m from water sources substantial presence, generally more than 30 m from shelters substantial presence, generally more than 30 m from water sources no substantial presence no substantial presence 4.5.4 Presence of solid waste, including household waste, building rubble, animal carcasses and animal faeces on and around the site substantial presence less substantial presence, than 50 m from shelters generally more than 100 m no substantial presence substantial presence less than 50 m from water sources from shelters substantial presence, generally more than 100 m from water sources no substantial presence 4.5.5 Presence of stagnant wastewater or rainwater on and around the site substantial presence less than 50 m from shelters substantial presence less than 100 m from shelters no substantial presence substantial presence less than 50 m from water sources substantial presence less than 100 m from water sources 4.6 ADDITIONAL COMMENTS CONCERNING SANITATION AT THIS SITE no substantial presence IRA FORM SECTION 4: WATER SUPPLY, SANITATION AND HYGIENE 14

4.7 HYGIENE 4.7.1 Proportion of households possessing soap Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 4.7.2 Proportion of households possessing one or more mosquito nets in good condition Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 4.7.3 Proportion of households possessing at least one narrow-necked water container (e.g. jerrycan) for storing drinking water Less than ¼ More than ¼, less than ½ More than ½, less than ¾ More than 3/4 4.7.4 Average total capacity of water containers per family (litres) 0-10 litres 11-20 litres 21-40 litres >40 litres Ne sait pas 4.8 ADDITIONAL COMMENTS RELATED TO HYGIENE AT THIS SITE E.G. ANY SPECIFIC OBSTACLES TO HYGIENE (PARTICULARLY HANDWASHING AFTER DEFECATION OR HANDLING FAECES OF CHILDREN AND SICK PEOPLE AND BEFORE FOOD HANDLING) NOT MENTIONED ABOVE, ANY PARTICULAR GROUPS WHO ARE EXCLUDED FROM ACCESS TO RESOURCES AND FACILITIES FOR HYGIENE: 4.9 WHAT ARE THE PRIORITIES EXPRESSED BY THE POPULATION CONCERNING WATER SUPPLY, SANITATION AND HYGIENE? IRA FORM SECTION 4: WATER SUPPLY, SANITATION AND HYGIENE 15

SECTION 5 NUTRITION AND FOOD SECURITY 5.1 RESOURCE PERSONS AND OTHER INFORMATION SOURCES: 5.2 EXISTING CAPACITIES AND ACTIVITIES: Organisation or person(s) responsible 5.2.1 Nutrition programs 5.2.2 Infant and young child feeding programs 5.2.3 Food aid programs 5.2.4 Food security/ livelihoods programs 5.3 FOOD AID: Normal / current activities Limitations to capacity or performance (lack of staff, materials and equipment, funds, access etc.) GENERAL FOOD DISTRIBUTION PROGRAMS (GFD): 5.3.1 Was a GFD program in place when the crisis began? 5.3.2 If yes: number of people (beneficiaries) who were receiving the general ration: 5.3.3 Types of beneficiaries who received the ration (i.e., who was targeted by the program): 5.3.4 Frequency of distribution (e.g. once per month): YES NO Other (specify) 5.3.5 Composition of the ration (i.e., list of foods included and their quantities): 5.3.6 Geographic areas covered by the GFD program (specify): SUPPLEMENTARY FEEDING PROGRAMS (SFP): 5.3.7 Was an SFP in place when the crisis began? YES NO Other (specify) 5.3.8 If yes: number of people (beneficiaries) who were participating in the SFP: 5.3.9 Types of beneficiaries who received the ration (i.e., who was targeted by the program, such as pregnant and lactating women): 5.3.10 Composition of the ration (i.e., list of foods included and their quantities): IRA FORM SECTION 5: NUTRITION AND FOOD SECURITY 16

5.4 FOOD CONSUMPTION: 5.4.1 Changes in the total amount of food that people are eating since the crisis began, on average: Amount consumed has increased Amount consumed is the same Amount consumed has decreased 5.4.2 Number of meals and snacks that adults were eating before the crisis, and number they are eating now, on average: Before the crisis : meals or snacks/day/adult Now : meals or snacks/day/adult 5.4.3 Number of meals and snacks that children <5 years of age were eating before the crisis, and number they are eating now, on average: Before the crisis : meals or snacks/day/child Now : meals or snacks/day/child 5.4.4 Changes in the types of foods that people are eating since the crisis began, if any: 5.4.5 Foods currently given to infants <1 year of age (in order of importance): 1. 2. 3. 5.5 OBSERVATION OF FOOD STOCKS IN A SAMPLE OF 10 OR MORE HOUSEHOLDS: 5.5.1 Estimated proportion of households that currently have food stocks. Household # people obtaining food primarily from this household Food stocks Quantity of food stocks (e.g. in kg) Household 1 YES NO Household 2 YES NO Household 3 YES NO Household 4 YES NO Household 5 YES NO Household 6 YES NO Household 7 YES NO Household 8 YES NO Household 9 YES NO Household 10 YES NO How long will these food stocks last (e.g. in weeks)? 5.6 FOOD ACCESS: 5.6.1 Frequency of theft, looting and destruction of food (in households, at markets or on farms) since the crisis began: Very common Somewhat common Not very common Other (specify) 5.6.2 Time it takes (walking) to reach the nearest market where food can be obtained: 5.6.3 Market (where food can be obtained) still functioning: YES NO Other (specify) IRA FORM SECTION 5: NUTRITION AND FOOD SECURITY 17

5.6.4 Availability and prices in the market of most commonly eaten foods: Specify the most commonly eaten foods for each: Currently available in the market: Cereals: YES NO Current price (specify unit): Remarks (e.g. on contradictory or surprising findings): Roots and tubers: YES NO Pulses and legumes: YES NO Oils and fats: YES NO Meat, fish and eggs: YES NO Vegetables and fruits: YES NO Milk and cheese (dairy) foods: YES NO Commercial infant formula: YES NO Food aid commodities: YES NO 5.6.5 Difficulties that traders or others are facing in reaching this market (check all that apply): Roads are impassable Insecurity Lack of trucks/transport 5.6.6 Livestock situation since the crisis began: Specify the animals for each: Large livestock: Small stock: Poultry or other small animals: Changes in animal numbers: - Note location of animals (e.g. if left behind) - Note extent of livestock losses (if any) Other (specify) Current availability of pasture and/or browse locally Sufficient Insufficient Sufficient Insufficient Sufficient Insufficient Other (specify) Other (specify) Other (specify) IRA FORM SECTION 5: NUTRITION AND FOOD SECURITY 18

5.7 SECONDARY DATA AND OBSERVATIONS FROM SPECIALISTS ON NUTRITIONAL STATUS: SUMMARY OF REPORTS AND OBSERVATIONS BY HEALTH AND NUTRITION SPECIALISTS ON NUTRITIONAL STATUS: 5.7.1 Reports and observations on current situation with acute malnutrition (moderate and severe) in children under 5 years of age: (Note the % children, age range, how malnutrition was Source: measured) 5.7.2 Reports and observations on the likely evolution of the acute malnutrition situation (moderate and severe) in children under 5 years of age over the next month: Source: 5.7.3 Summary of reports or observations of acute malnutrition in adults (especially pregnant or lactating women) or adolescents: Source: SUMMARY OF SECONDARY DATA FROM THE AREA ON NUTRITIONAL STATUS: 5.7.4 Vitamin A distribution in the last 12 months for children 6-59 months of age: YES NO Other (specify) Source and year: 5.7.5 Vitamin A distribution in the last 12 months for women after delivery: YES NO Other (specify) Source and year: 5.7.6 Percent of children 6-59 years with wasting (insufficient weight for height): (Note whether total or severe, how it was Source and year: measured) 5.7.7 Percent of children 6-59 years with stunting (insufficient height for age): (Note whether total or severe, how it was Source and year: measured) 5.7.8 Percent of children 6-59 years with underweight (insufficient weight for age): (Note whether total or severe, how it was Source and year: measured) 5.7.9 Percent of pregnant women with BMI <18.5: 5.7.10 Percent of pregnant women 18-45 years of age with anaemia: Source and year: Source and year: 5.8 MAIN CONCERNS REPORTED BY THE POPULATION (WOMEN AND CARETAKERS) AND BY HEALTH PROFESSIONALS RELATED TO INFANT AND YOUNG CHILD FEEDING: Reported by the population (women and caretakers): Reported by health professionals: 5.9 ADDITIONAL COMMENTS RELATED TO NUTRITION, FOOD SECURITY, OR INFANT & YOUNG CHILD FEEDING AT THIS SITE: IRA FORM SECTION 5: NUTRITION AND FOOD SECURITY 19

IRA FORM SECTION 5: NUTRITION AND FOOD SECURITY 20

SECTION 6 HEALTH RISKS AND HEALTH STATUS 6.1 RESOURCE PERSONS (INCLUDING MEANS OF CONTACT IF ANY) AND OTHER INFORMATION SOURCES: 6.2 NEAREST HEALTH FACILITY: 6.2.1 Name and place: Facility type: 6.2.2 Who provides health care in that facility? (Check all that apply) Nurse Doctor Midwife Other (specify) 6.2.3 Who manages that facility? Ministry of Health Other (specify) 6.2.4 Access to nearest health facility (check one): Easy With obstacles (Explain) Very difficult (Explain) Distance in km: 6.2.5 Who else provides health care services for the community? Community health worker Traditional healer Traditional birth attendant Other (specify) 6.3 HEALTH PROFILE: Morbidity (disease in population) 6.3.1 Main health concerns reported by the population (list) 1. 2 3 6.3.2 Main health concerns reported by health professionals (list) 1 2 3 6.3.3 Have there been any reports or rumours of any outbreaks or unusual increases in illness? No Yes (Specify) 6.3.4 Have there been reports of trauma or injury? No Yes (Specify 6.3.5 Have there been reports of sexual and gender based violence (SGBV)? No Yes (Specify) IRA FORM SECTION 6: HEALTH RISKS AND HEALTH STATUS 21

6.3.6 Are there patients suffering from chronic diseases among the affected population? No Yes (Specify) 6.3.7 Have there been reports of non-infectious agents (such as cold, heat, radiation, poisons or toxins)? No Yes (Specify) 6.3.8 What are the main manifestations of psychosocial needs among the affected population? 6.3.9 Other causes of morbidity? (Specify) Disease Control and Prevention 6.3.10 Local measles vaccination rate of under-5s 6.3.11 Existence of special disease control programmes? (specify) No Yes (Specify) 6.3.12 Impact of crisis on disease control programmes? (specify) Mortality (deaths) 6.3.13 Existence of mortality surveillance (is the community counting deaths?) No Yes (Specify) 6.3.14 Number of deaths of people over-5 in the last seven days (specify among how big a population) Source: 6.3.15 Number of under-5 deaths in the last seven days (specify among how big a population) Source: 6.3.16 Was there a change in the mortality pattern since the beginning of the crisis? No Yes (Specify) Source: 6.3.17 Comments on health profile 6.4 HUMANITARIAN INTERVENTION: 6.4.1 Current humanitarian interventions Organization : 1 2 3 Main activity: IRA FORM SECTION 6: HEALTH RISKS AND HEALTH STATUS 22

SECTION 7 HEALTH FACILITY ASSESSMENT (fill one for each health facility visited) 7.1. HEALTH FACILITY 7.1.1 Name of facility: 7.1.2 Kind of facility: Contact : 7.1.3 Place : 7.1.4. District, province: 7.1.5 Ownership 7.1.6. Management 7.1.7 Closest referral facility: 7.2. RESOURCES 7.2.1 Infrastructure (e.g. buildings, heating, water, sanitation, waste disposal, electricity): Intact/functioning Damaged/malfunctioning Destroyed / not functioning 7.2.2 Essential equipment: Available/functioning Partly missing/malfunctioning Missing/destroyed 7.2.3 Supplies essential drugs: Available Partly available Missing 7.2.4 Supplies EPI vaccines: Main shortages: Main shortages: Available Main shortages: Partly available Missing 7.2.5 Supplies consumables (e.g. syringes, dressing material): Available Main shortages: Partly available Missing 7.2.6 Human resources: (provide numbers per category) : Doctors Nurses Midwives Others (specify) No.: No.: No.: No.: Main shortages: 7.2.7 Finances (e.g. staff income, maintenance expenses): Regular / at pre-crisis level Diminished Ended Main shortages: IRA FORM SECTION 7: HEALTH FACILITY ASSESSMENT 23

7.2.8 Present external support to resources: 7.3. PERFORMANCE Process and output indicators 7.3.1 Post-crisis change in number of general consultations per day, deliveries per day: (define) Increased Unchanged Diminished Stopped 7.3.2 Post-crisis change in preventive care activities (e.g. vaccinations, antenatal care consultations) per day: (define) Increased Unchanged Diminished Stopped 7.3.3 Contribution to health information system: Regular/on time Irregular/late None 7.3.4 Supervisory visits: Regular Irregular None 7.3.5 Observations: Quality indicators 7.3.6 Standardized case management (e.g. for malaria, diarrhoea, respiratory tract infections, IMCI, STIs): Yes No 7.3.7 Referral mechanism: Defined/regular Ad hoc/irregular None 7.3.8 Availability of patient records: Yes No 7.3.9 Universal precautions (e.g. sharps disposal): Satisfactory To be improved Substandard IRA FORM SECTION 7: HEALTH FACILITY ASSESSMENT 24

7.3.10 General hygiene: Satisfactory To be improved Substandard 7.3.11 Observations : 7.4 ACCESS TO THE HEALTH FACILITY 7.4.1 Limits to access to health services (e.g. financial, geographical, cultural, security): 7.4.2 Post-crisis change with regard to access: IRA FORM SECTION 7: HEALTH FACILITY ASSESSMENT 25

7.5 FUNCTIONING OF SUB-SECTORS AND SERVICES Sub-sectors and services 7.5.1 General clinic services (outpatient and, where applicable, inpatient services) 7.5.2 Mother-and-child health 7.5.3 Reproductive health Normal Decreased Not functioning Does not apply Observations : 7.5.3.1 Normal deliveries 7.5.3.2 Emergency obstetric care 7.5.3.3 HIV/AIDS Prevention 7.5.3.4 Management of victims of sexual violence 7.5.5 Emergency surgery 7.5.6 Mental health 7.5.7 HIV/AIDS treatment 7.5.8 Nutrition 7.5.9 Expanded program of immunizations (EPI) 7.5.10 Communicable disease control 7.5.11 Health education/promotion 7.5.12 Community health services 7.5.13 Epidemic preparedness 7.5.14 Laboratory 7.5.15 X-ray 7.5.16 Dispensary/pharmacy 7.5.17 Other (specify) 7.5.18 Other (specify) 7.5.19 Other (specify) 7.5.20 Comments on sub-sectors and services: IRA FORM SECTION 7: HEALTH FACILITY ASSESSMENT 26

United Nations Inter-Agency Standing Committee (UN IASC) Health Cluster Nutrition Cluster WASH Cluster INITIAL RAPID ASSESSMENT (IRA) TOOL: GUIDANCE NOTES Prepared jointly by: IASC Health Cluster IASC Nutrition Cluster IASC WASH Cluster 1 January 2008 IRA GUIDANCE NOTES 27

Why would you do an IRA? Who should do an IRA? When would an IRA be done? How should an IRA be organized? How should the IRA be done? Can the IRA be used in all contexts? Initial Rapid Assessment (IRA) Tool Overview The Initial Rapid Assessment (IRA) is designed to: Provide a very quick overview of how a population has been affected by a crisis, including who is likely to be at greatest risk of mortality and acute morbidity and why, and Identify priorities within and across sectors for an initial comprehensive humanitarian response and follow-on sector-specific assessments. Multi-agency teams, including national government institutions, UN agencies, INGOs and national non-governmental institutions should in most cases conduct the IRA, to build national capacity as well as strengthen the assessment through the complementarity of views and expertise. The IRA Form is designed for use by assessment team members without advanced training in the sectors covered by the assessment. Broad public health training is advantageous, particularly in terms of rapid assessment methods and familiarity with best practices in the major content areas. Assessment team leaders should have broad public health and experience. The IRA is designed primarily for new rapid-onset crises. The IRA may also be used in newly accessible areas that were previously inaccessible as well as in chronic emergencies, particularly if affected by a sudden shock or deterioration in conditions. Because speed is vital, the IRA should be started as soon as possible after the onset of a crisis. Initial reporting for decision makers and funding appeals should quickly follow completion of fieldwork; ideally, the whole process should be completed within a few days. The decision to carry out an IRA will usually be taken at country level, through discussion between the UN Country Team (UNCT), led by the Humanitarian Coordinator (HC) in emergency situations, or the UN Resident Representative in other situations, and the government concerned. In countries where the Cluster system is established, the choice of locations for the IRA will be made by the involved country Clusters. Whether or not the Cluster system is in place, the IRA requires and encourages strong multi-sector coordination. The IRA should represent the best picture of the situation that the assessment team can develop, based upon a review of secondary data, and primary data collected using qualitative methods: individual key informant interviews, group interviews, observation and other techniques. The IRA form, which should be filled out once for each site being assessed, is the format the team should use to put it all together into a coherent, systematic summary of the situation and needs for major response. Assessment team members can use the IRA Form as a checklist for data collection, as a reporting template, and as a worksheet for taking notes on data collected if they prefer to use it that way. The IRA is meant to be generic, so it can be used across contexts and countries. Variations in language, cultural acceptability and health/public health systems and services will require country-specific adaptations. It is important, however, that the IRA Form maintains a common identity across countries. If needed and time allowing, crisisspecific adaptation can be made during fieldwork. IRA GUIDANCE NOTES 28

ACRONYMS HC IASC INGO IRA NGO UN UNCT WASH Humanitarian Coordinator Inter-Agency Standing Committee International non-governmental organization Initial rapid assessment Non-governmental organization United Nations United Nations Country Team Water, sanitation and hygiene promotion IRA GUIDANCE NOTES 29

TABLE OF CONTENTS 1. INTRODUCTION 44 1.1 Background. 44 1.2 Purpose and objectives of the IRA.. 44 1.3 Timing of the IRA.. 45 1.4 Roles and responsibilities 45 1.5 Structure of these Guidance Notes.. 45 2. THE IRA AT COORDINATION LEVEL... 47 2.1 IRA coordination and preparedness 47 2.2 Development of locally-adapted country edition of IRA Tool.. 47 2.3 Secondary data 48 2.4 Formation of field assessment teams.. 49 2.5 Selection of sites for data collection 51 2.6 Planning and coordinating fieldwork.. 52 2.7 Analysis.. 52 2.8 Reporting. 53 3. THE IRA AT FIELD LEVEL.. 55 3.1 Briefing/training of assessment team.. 55 3.2 Secondary data collection in the affected area 55 3.3 Primary data collection at affected sites. 56 3.4 Bias and triangulation. 58 3.5 Completing the IRA Form.. 58 4. ANNEXES 59 A Recommended further reading 59 B Data collection and recording notes for the IRA Form... 61 IRA GUIDANCE NOTES 30

1. INTRODUCTION 1.1 Background The Initial Rapid Assessment (IRA) Tool was developed by the United Nations Inter-Agency Standing Committee (UN IASC) Health, Nutrition and WASH Clusters in 2006-2007. The IRA aims to enable faster and better multi-sector rapid assessment in the earliest hours of a sudden-onset crisis, to guide the planning of urgent humanitarian interventions, to identify needs for follow up assessments, and to inform funding decisions. The IRA is designed to be used in the field by team members without specialized technical expertise (e.g., in humanitarian assessment, or in health or water programs), to ensure that essential data can be collected and reported for a site within 24-48 hours. The methods used multiple qualitative techniques for primary data collection backed up by secondary data review provide for both speed and the necessary level of data quality. 2 The IRA Tool includes two key documents: the IRA Form and these Guidance Notes. The IRA Form should be used to guide data collection in the field, to assist with data recording, and to structure the reporting of those field data. These Guidance Notes provide instructions and suggestions on how to prepare for and implement the IRA. 1.2 Purpose and objectives of the IRA The purpose of the IRA is to provide a rapid overview of the emergency situation, in order to identify the immediate impacts of the crisis, estimate needs of the affected population for assistance, and to define the priorities for humanitarian action (and funding for that action) in the early weeks. The objective of the IRA is to answer the following core questions: 1. What has happened? Is there an emergency situation and, if so, what are its key features? 2. How has the population been affected by the emergency? Who is likely to be most vulnerable and why? How many people were affected, and where are they? 3. Are interventions required to prevent further harm or loss of life? If so, what are top priorities for assistance? 4. What are continuing or emerging threats that may escalate the emergency? 5. What resources and capacities are already present (e.g., infrastructure and institutions) that could assist in the response, and what are the immediate capacity gaps? 6. What are the key information gaps which should be addressed in follow up assessments? Figure 1 illustrates the position of the IRA in the emergency assessment process. Data provided by the IRA is preliminary, and the quality of the data is determined by the skills of the assessment teams. The IRA should identify what types of more detailed sector-specific assessments should be conducted, which would then provide more statistically rigorous or qualitatively nuanced details for program planning. 2 The word data is used in these Guidance Notes to mean simple bits of information that may be quantitative or qualitative. This data will then be analysed within the country context to produce the information needed to make recommendations and decisions for evidence based action. A distinction is made here between primary and secondary data. Primary data is gathered directly by observation or interviews with people directly affected by or working in the crisis. Secondary data comes indirectly in the form of written or verbal reports, maps and images. Both are required to complete the IRA. 31

1.3 Timing of the IRA The IRA should be launched as soon as possible after the onset of an acute crisis. It can also be used in chronic emergency situations that become more acute; and when there is access to areas that have been previously inaccessible due to insecurity, weather conditions or other obstacles. Fieldwork and reporting should be completed within a matter of days if the scale of the crisis, the number of assessors available, travel times and the number of sites to visit allow. After one week it is likely that there will be substantial capacity for more in-depth and sector-specific assessments (if needed) and the IRA will become less relevant. Some steps of the IRA are best done in advance, as part of a national disaster preparedness effort. These are discussed in Section 2.1. 1.4 Roles and responsibilities The IRA was developed as a tri-cluster initiative. While the cluster approach need not be established for the IRA to work, strong intra-sectoral and inter-sectoral coordination mechanisms should be in place. The UN Country Team (UNCT), led by the Humanitarian Coordinator in emergency situations, assures overall coordination and technical coordination (by sector or cluster) within the UN system and NGOs under the IASC framework. The IRA should be carried out within this coordination mechanism and, wherever feasible, with national government partners. Conducting an IRA takes place at two levels: coordination and field. At Coordination Level, two main types of coordination are required: administrative/operational coordination (or overall coordination ), and technical coordination and oversight. The functions and activities at coordination level are dealt with in Section 2 of these Guidance Notes. At Field Level, two types of actors are involved: Team Leaders and Team Members. The functions and activities at field level are dealt with in Section 3 of these Guidance Notes. Table 1 lists the various activities involved in preparing for and carrying out an IRA and suggests which actors will take responsibility for each activity. 1.5 Structure of these Guidance Notes These Guidance Notes are intended to help people involved with the IRA at coordination and field levels to prepare for, organize and carry out an IRA, analyse the data collected to make essential decisions on immediate response, funding and/or follow on assessments. Section 2 is primarily aimed at coordination level and Section 3 is mainly aimed at field level. The sections most relevant to different actors involved in the IRA are shown in Table 1. Staff carrying out the IRA in the field should refer to the step-by-step guidance on data collection and recording in Annex 4. Where time is available, users of the IRA at all levels should read all sections. People participating in an IRA at all levels are also encouraged to refer to existing, comprehensive emergency assessment references from IFRC, SPHERE, UNICEF and others (see reference list in Annex 1). 32

Figure 1. Initial rapid assessment in the emergency assessment and monitoring process 3 Increasing depth P re -C ris is P re p a re d n e ss d a ta co lle c tio n E a rly w a rn in g s ys te m s S urveillance P e rio d ic su rve ys E m e rg e n c y Im m e d ia te R e s p o n s e P h a s e Initial M u lit-s e c to r a l R a p id A s srapid e s s m e n t (qassessm u a lita tive & s e c o n d a ry q u a nent tita ti ve ) T ra c k in g S e c to r-s p e c ific r a p id assessm en ts M u lti-s e c to r a l s u rv e y (p ro b a b ility s a m p le ): H e a lth /N u tr/ F o o d /W A S H /e tc B e y o n d th e Im m e d ia te R e sp o n s e F o llo w -u p s u rv e y : H e a lth /N u tr/ F o o d /W A S H /e tc E xis tin g re s e a rc h /s tu d ie s P r e p a r e d n e s s M o n ito r in g S u d d en o n s e t P e rfo r m a n c e M o n it o r in g In -d e p th s e c to r s tu d ie s (quantitative /qualitative ) 1 w k 6-8 w k s 3-6 m o 1 y e a r Table 1. Key roles and responsibilities in IRA implementation IRA steps Actors responsible Administrative and operational coordination Coordination Level Technical coordination and oversight Development of IRA Tool country edition Team leaders Field Level Team members Guidance Notes Section(s) 2.2 Secondary data analysis/review, mapping Formation of IRA field teams Administrative/operational coordination of IRA Briefing and management of IRA Team Members Primary data collection, compilation and analysis at field level Analysis at coordination level Dissemination / reporting / decision making 2.3 2.4 2.5, 2.6 3.1 3.2-3.5 2.7 2.8 3 Adapted from: UNICEF. Cross-Sectoral Rapid Assessment: Rapid Onset Emergencies, The First 72 Hours (DRAFT). New York, 2006. 33

2. THE IRA AT COORDINATION LEVEL 2.1 IRA coordination and preparedness The IRA can be conducted in an acute-onset crisis without advance preparation. However, field testing identified actions that could greatly increase the validity and utility of IRA findings if undertaken in advance. These actions fall into three categories: 1. Institutional: Including establishing roles, responsibilities and coordination mechanisms in country. 2. Technical: Including developing the country edition of the IRA Tool, including the Form, Guidance and any other country-specific documents; as well as pre-crisis information management. 3. Implementation planning: Sensitization of key humanitarian stakeholders; identification and preparation of potential team leaders; and other planning considerations. The IRA involves many actors and sectors, and centralized coordination is essential. If a strong, engaged national focal point institution exists, it may assume this role of providing overall coordination, but equally it may be filled by OCHA or another humanitarian focal point. This is primarily an administrative/operational rather than technical function. For example, it includes formally launching an IRA, but the decision to conduct an IRA is made at the coordination/cluster level by technical specialists. The administrative/operational coordination role involves some or all of the following: 1. Launching the IRA based on decisions at coordination/cluster level 2. Coordinating (administratively and operationally) 3. Security management 4. Overseeing the timing of the assessment, information management and appeals processes 5. Linking IRA with other assessment processes 6. Ensuring adequate participation of relevant actors in the IRA In contrast, technical coordination and oversight should be provided by agencies with advanced technical expertise. The technical coordination/oversight role involves some or all of the following: 1. Deciding that an IRA should be launched based on information available about the crisis 2. Assisting in selection and briefing of Team Leaders 3. Assisting in selection and/or briefing of Team Members 4. Possibly joining the field assessment team The coordination group that undertakes an IRA should generally include: main governmental stakeholders; UN cluster leads, OCHA, other UN agencies active in the country; and Red Cross/Red Crescent, INGOs and NGOs active and interested with capability to participate. This group should include technical specialists, e.g., program managers. 2.2 Development of IRA Tool country edition Although the global IRA Tool was written to be as universally applicable as possible, some adaptation may still be required for country use, particularly for the IRA Form. Where possible, a country edition of the IRA Tool should be produced as a preparedness measure to make it easier to pull the IRA Tool off the shelf and go to the field in an acute crisis. A country edition of the IRA Tool should be based upon technical inputs of a range of stakeholders across sectors. Any adaptations should be made as a joint effort involving the main actors likely to be involved in implementing the IRA. Whether or not a country edition of the IRA Tool has been produced before a crisis, the IRA Form should always be reviewed in advance of fieldwork to ensure it is locally appropriate and feasible in that setting. In order to ensure consistency and comparability of field assessment data, any additional adaptations of the IRA Tool made during a crisis should be made very early in the assessment (i.e., by 34

the first day of fieldwork) and should be agreed upon by the field teams (and if possible, the coordinating group). Changes should be kept to a minimum, to save time, keep a common identity across countries and ensure that the information is provided in a predictable and familiar way. If the IRA form is altered for use in a crisis, the locally adapted version should be kept on file alongside the country edition. Box 1 provides some guidelines for national and local adaptation of the IRA Form. Box 1. Parameters of IRA Tool adaptation Where changes to the IRA Form are most likely to be required: 1. If the population is highly urbanized 2. If multiple populations are affected, such as refugees, IDPs and host communities (for example, this would complicate Section 2.4 of the IRA Form) 3. Population movements and leadership types present in the crisis-affected community (Section 2.3) 4. Specific examples may be inserted for shelter types (Section 3.2), cooking fuels (Section 3.3.3), means of artificial lighting (Section 3.3.7), food items (Section 5.6.4), animals (Section 5.6.6), problems with infant and young child feeding (Section 5.8), and health subsectors and services (Section 7.5). 5. Local units may be inserted alongside international/metric units for distance, volume or weight. 6. Local terms and definitions for meals and snacks may be required for Section 5.4. 7. If the population is not pastoral, Section 4.3.11 is not relevant. If it is relevant, questions about animals may require clarification. Where altering the IRA Form is discouraged, to preserve core data requirements: 1. Ranking system for ranking needs (Summary) 2. Identification information (Section 1) 3. Population description (Section 2). Although acquiring this information may be difficult, estimates of the population, and various subgroups is important for humanitarian programming. Alterations should aim to get this information as much as possible. 4. In other sections, any modifications should focus on clarification, or removing items that are clearly inappropriate or highly sensitive, or adding content. 2.3 Secondary data Pre-crisis secondary data: Where possible, the following categories of secondary data should be assessed, collected and consolidated in a national database as an integral part of a national preparedness strategy: 1. Baselines for health and population statistics, access to services and livelihoods for comparison with in-crisis conditions; 2. Pre-crisis vulnerabilities of the population, and the factors that create these vulnerabilities; 3. National and international capacities for emergency response as well as critical gaps therein; 4. Enabling and limiting factors in the institutional context for the humanitarian response (e.g. code on breast milk substitutes, protocols for feeding programs); and 5. Topography, climate, water resources, infrastructure and land use, which are important for understanding available resources and constraints on a possible response. The main sources for pre-crisis data will include government offices, the statistical bureau, bureaus of multilateral and bilateral donor organizations, universities, research centres and think tanks, UN agencies including OCHA and/or the humanitarian information centre if present, NGOs, and global or regional databases. 35