LEARNING OBJECTIVES At the end of the course, the participants shall be able to:

1.

Define the four thematic areas of DRRM-H;

2.

Identify the roles and goals of each of the four thematic areas in developing a plan;

3.

Identify the different planning processes for each of the four thematic areas; and

4.

Discuss the strategies of the thematic areas of DRRM-H.

CLUSTER APPROACH Disaster Risk Reduction and Management (DRRM) covers various sectors with different specific

concerns and corresponding operations. Hence, clusters have been established to strengthen coordination in times of emergency. This allows the different sectors or groups to perform their respective roles and still fulfill the common goal of DRRM. Three of the 11 internationally recognized clusters are health, nutrition, and water sanitation and hygiene (WASH). In the Philippines, nutrition and WASH clusters are recognized as sub-clusters of health; along with two added sub-clusters namely medical and public health; and mental health and psychological support (MHPSS). The overall responsible agency for this cluster is the Department of Health (DOH). These health sub-clusters are the focus of the third step of DRRM-H Planning or the development of strategies and activities to address the hazards, vulnerabilities, and risks identified. Each sub-cluster has its component services, as listed below.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

THEMATIC AREAS OF DRRM-H Consistent with the structure of the National Disaster Risk Reduction and Management Council (NDRRMC), the health cluster also covers the same four thematic areas of DRRM, namely: (1) Prevention and Mitigation; (2) Preparedness; (3) Response; and (4) Recovery and Rehabilitation. These thematic areas are in line with the vision of the National Disaster Risk Reduction and Management Framework (NDRRMF) of a “safer, adaptive, and disaster-resilient Filipino communities toward sustainable development.

The first thematic area is prevention and mitigation. Its goal is to avoid hazards and mitigate their potential impacts. This can be done by reducing vulnerabilities and exposure and enhancing the capacities of communities. Specifically, prevention and mitigation in health aims to: A. Reduce risks in health infrastructure through engineering and maintenance; B. Strengthen day-to-day operations of different health programs (Tuberculosis, Malaria, Expanded Program on Immunization, etc.) at the community level; and C. Prepare systems to address chemical and biological hazards (Malaria, emerging and re-

emerging diseases, etc.) It is expected from prevention and mitigation initiatives that hazards are avoided, vulnerabilities reduced, impacts mitigated, and DRRM-H capacities enhanced. Furthermore, these activities must also result to mainstreamed DRRM-H and Climate Change Adaptation (CCA) policies, plans, and budget; DRRM and CCA sensitive and adaptive health systems; health resilient health facilities; and communitybased scientific health risk assessment, mapping, analysis and monitoring.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

The goal of preparedness is to establish and strengthen capacities of communities and local government units (LGUs) to anticipate, cope and recover from the negative impacts of emergency occurrences and disasters. Additionally, it aims to reduce identified health risks and strengthen capacities to improving internal and external DRRM-H institutionalization. Its objectives are: A. Increase capacity to efficiently manage the health risks of emergencies and disasters and achieve orderly transitions from response until recovery; B. Ensure DRRM-H institutionalization internally and in constituent cities/municipalities or barangays; and C. Build health system resilience by maintaining DRRM-H in all health programs. Strategies on preparedness processes must include the following: A. Policies, protocols, procedures, and guidelines B. Plans C. People D. Partnership building E. Program development

F. Physical infrastructure development G. Practices H. Peso and logistics I. Promotion and advocacy J. Performance management These strategies are expected to help strengthen DRRM-H capacities, which will then result to communities’ awareness and understanding of health risks, to a proper DRRM-H plan, training drills, exercises, logistics, and developed systems.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

In response, the goal is to provide life preservation through uninterrupted health service delivery

during emergencies and disaster. Specifically, response in health aims to: A. Ensure availability of critical lifelines related to health (e.g. safe water, electricity/fuel, communi cation devices); and B. Guarantee physical and mental wellness of affected communities through quad-cluster

response (Medical and Public Health, Water Sanitation and Hygiene, Nutrition, and Mental Health and Psychological Support). Response, as a thematic area, is composed of three phases: (1) pre-disaster or the day/s before the occurrence of disaster; (2) during disaster, which happens 0-48 hours; and (3) post-disaster, which pertains to the period after the disaster itself. These three phases in response all focus on proper management of different resources. Pre-Disaster Phase This phase consists of management of (1) the impending event/incident; (2) population potentially affected; (3) service providers; (4) non-human resources; and (5) information. Management of the event/incident mostly pertains to activation of systems, particularly: (a) code alert system; (b) incident command system or ICS; and (c) early warning alert response system or EWARS. It also includes conduct of inter, intra, and inter-sectoral coordination meetings. These steps in pre-disaster phase are expected to result to a conduct of rapid health assessment (RHA) and of health operations in the four sub-clusters of health, as well as mobilized and augmented resources, tapped partnerships, and a conduct of monitoring and evaluation.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

The second area to be managed is the population potentially affected. This includes preparation for the health services in the evacuation centers, setting up of standy-by teams or Department of Health (DOH) representatives in their respective areas of assignment, and an identification of an alternative health facility. Aside from potentially-affected population, management of service providers are also given importance in the pre-disaster phase. In managing service providers, the events/incidents must first be verified or validated. There has to be coordination with the affected area/s to determine possible actions or interventions. As for deployment, the affected area/s must be assessed in terms of safety and security, and the Health Emergency Response Teams (HERTs) must be notified. At all times, the HERTs’ selfsufficiency and security must be ensured. Furthermore, pre-disaster also takes into account the non-human resources. Management of nonhuman resources includes checking and mobilization of inventory; prepositioning of logistics/ checking of all other logistic requirements; and checking the availability of funds, including Quick Response Fund (QRF), Contingency Fund, and other sources of emergency fund. Lastly is the management of information. This includes activation of Operations Center, collection of data about the hazard/event and its possible effect/impact, and conduct of risk assessment using pre -disaster information. During Disaster This phase, which usually occurs for 0-48 hours, consists of management of (1) the event/incident; (2) victims; and (3) information. When managing event/incident during disasters, alert codes must be monitored and updated as necessary. There should also be a coordination meeting, and an implementation of initial Incident Action

Plan. It must be noted that if there is a lack of warning, the priority key action would be to implement activities cited in the pre-disaster phase. Health services should be uninterrupted to avert morbidities and mortalities and outbreaks secondary to disasters. Meanwhile, management of victims is to provide public health, pre-hospital and hospital services that target the four sub-clusters of health: medical and public health, water sanitation and hygiene, nutrition, and mental health and psychological services. Information is also managed during disasters by gathering RHA, deploying RH Teams as neces-

sary, and by preparing report to be disseminated to partners. DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

Post-Disaster Phase Like the pre-disaster phase, post-disaster also consists of the management of (1) the event/ incident; (2) victims; (3) service providers; (4) non-human resources; and (5) information. While the two phases have the same resources or areas to be managed, they however differ in set-up; thus, they also have different sets of actions per area management. In post-disaster, management of the event/incident means coordinating with local, regional or territory counter-disaster controllers of higher and lower levels. Meanwhile, management of victims is a continuous provision of public health, pre-hospital and hospital services as what should have been provided even during disaster. Furthermore, management of service providers after disaster is to mobilize and monitor HERTs, and to demobilize HERTs based on the criteria indicated in the Administrative Order No. 2018-0018 on the National Policy on the Mobilization of HERTs. As for non-human resource management, there should be an inventory of all resources for replacement, repair, or reconstruction. Lastly, management of information pertains to a continuous monitoring and analysis of data/ information, and collection of more detailed data for appropriate emergency actions.

The last thematic area is recovery and rehabilitation. Its main goal is to restore and improve facilities and organizational capacities of LGU operations and reduce disaster risks in accordance with the “build back better” principle. Its objectives are to: A. Assess long-term health needs of community to guide recovery efforts; and B. Maximize opportunities to further increase community health resilience.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

The expected outcomes from recovery and rehabilitation initiatives are restored and improved health facilities and living conditions based on the “build back better” principle. This thematic area is also responsible for the restoration and mainstreaming of services; the repair, rehabilitation, and construction of infrastructure; promotion of mental health; replenishment of logistics; renewal of partnerships; evaluation of post incident including documentation of lessons; and for research and development.

SUMMARY •

A cluster approach in Disaster Risk Reduction and Management was established to strengthen coordination in terms of emergency. In the Philippines, one of the clusters is health. The health cluster has four sub-clusters-- nutrition, and water sanitation and hygiene (which, in international standards, are both recognized as main clusters), medical and public health, and mental health and psychological support (MHPSS).

•

The health cluster covers the same thematic areas of DRRM, namely: (1) Prevention and Mitigation; (2) Preparedness; (3) Response; and (4) Recovery and Rehabilitation.

•

The first thematic area is prevention and mitigation. Its goal is to avoid hazards and mitigate their potential impacts by reducing vulnerabilities and exposure, and by enhancing capacities of the LGUs and communities.

•

Preparedness, as the second thematic area, aims to establish and strengthen capacities of LGUs and communities to anticipate, cope, and recover from the negative impacts of emergency occurrences and disasters.

•

The third thematic area is response. Its objective is to provide life preservation through uninterrupted health services delivery during emergencies and disaster.

•

The last thematic area, recovery and rehabilitation, aims to restore and improve facilities and or-

ganizational capacities of LGU and community operations and to reduce disaster risks in accordance with the “build back better” principles.

DRRM-H PLANNING GUIDE: Module 4 [Thematic Areas of DRRM-H: Cluster Approach]

This course material was produced in 2019 by the “Development of eLearning Modules for the Department of Health” project implemented by the University of the Philippines Open University and funded by the Department of Health Health Human Resource Development Bureau.

PRODUCTION TEAM Course Package Developer: Queenie R. Ridulme Rita C. Ramos Online Pedagogy Expert: Dr. Myra D. Oruga Resource Person: Dr. Maridith Afuang Online Learning Object Specialist: Rhea Ariele Pascua Rachel Ann Joyce Sales Scriptwriter: Rhea Ariele Pascua Rachel Ann Joyce Sales Style Editor: Rhea Ariele Pascua Rachel Ann Joyce Sales