| Indicator ID | H14 |
|---|---|
| Indicator full statement | The number of all outpatient consultations conducted by Tdh (Terre des hommes) services during a specified period in an emergency context. |
Purpose
| Importance | The primary aim of this indicator is to measure the volume of outpatient consultations provided by Tdh health services during emergencies. It assesses the reach and accessibility of outpatient care and Tdh's capacity to address immediate health needs in such situations. By providing insights into the use of health services by the target population, this indicator evaluates the accessibility and utilization of preventive and curative care, which is vital for reducing mortality and improving health outcomes during health emergencies. |
|---|---|
| ToC pathway | This indicator aligns with the ToC for health programme, contributing to three inter-related pathways of change: 1) local health systems, 2) communities, and 3) mothers, children, and their families. |
| Related services | It is used depending on the service provided by Tdh. This indicator is often used in emergency response, according to Tdh Package of activities. |
Definition
The total count of individual outpatient consultations provided by Tdh services.
Outpatient consultations are defined as health care visits where patients receive medical advice, diagnosis, treatment, and/or follow-up care without being admitted to a health facility (which would be referred as inpatient consultations).
How to collect & analyse the data
| What do we count? | Consultations |
|---|---|
| How to calculate the indicator's value | Sum of consultations |
| Data sources | Health facility records: Documentation of each outpatient consultation recorded by Tdh health facilities (i.e., patient registers). Program reports: Regular reports from Tdh supervision teams detailing the number of consultations provided. Digital Health Information System (DHIS): Data from digital health management systems tracking outpatient consultations (i.e., REC). |
| Data collection methods and tools | Secondary data review :
|
| Disaggregation | Data should be stratified by
Where appropriate depending on the data source. |
| Important considerations | Frequency and timing As this indicator is key to monitor program outputs in acute emergency, we recommend daily or weekly reporting. Then, aggregated data for monthly, quarterly, and annually reporting for comprehensive analysis. |
Limitations and precautions
In settings with weak health information systems (i.e., non-digital health facility records, insufficient means of communication) or incomplete vital registration (i.e., overstretch health workforce), data from health facilities may be incomplete or inaccurate, requiring triangulation with other sources of information such as household survey, which might be difficult to implement in emergency settings. Strengthening DHIS is key to gain timely and accurately access to outpatients’ consultations data.
This indicator cannot be used to presume the quality of care delivered, especially considering that a health crisis might have negative impact on the healthcare delivery system (i.e., lack of preparedness, material and equipment, overload staff leading to substandard practices), but it can provide key information on the type of consultations and/or diseases that needs further emergency support such as medicines, specific digital protocols, and decision-making tools.
Rural and remote areas often lack access to skilled health personnel or well-equipped facilities, which can lead to underreporting of outpatients’ consultations. Similarly, marginalized, or lower socioeconomic groups may face financial barriers, limiting their access to high-quality care even if primary health care services are available. These factors are often not captured by the indicator, masking inequalities in access to healthcare.
What further analysis are we interested in?
This indicator assesses the volume of outpatient consultations provided, enabling the identification of trends or changes over time. It is crucial during health crises, as significant variations in attendance may occur rapidly due to factors like population influxes, uncontrolled epidemics, or war injuries. A cross-analysis of this indicator with the availability of health facilities, skilled personnel, and barriers to access—such as geographic distance, costs, cultural factors, and gender-sensitive services—provides a comprehensive view of emergency healthcare access in a specific area.
Outpatient consultation coverage measures healthcare utilization and offers insights into the effective population receiving care. When analysed alongside other indicators of preventive and curative care availability (like out-of-stock days for essential medicines), it enhances the understanding of utilization and provision synergy.
It is important to consider sociocultural norms and traditional beliefs, as these factors can influence access to quality care. Qualitative research on cultural beliefs and gender dynamics may further illuminate health-seeking behaviours. Comparing outpatient consultation coverage across regions or time frames allows for trend and equity analyses regarding healthcare access.
Finally, this indicator helps measure the impact of interventions aimed at improving population health outcomes.
Additional guidance
Under the technical assistance of HQ, Tdh M&E and operational teams in each delegation should work closely with health authorities, Health Cluster members and representative (or equivalent working and coordination group, if relevant in this emergency context) and DHIS providers to collect and interpret the data.
Sphere Association. The Sphere Handbook: Humanitarian Charter and Minimum
Standards in Humanitarian Response, fourth edition, Geneva, Switzerland, 2018. Available at:
www.spherestandards.org/handbook (Accessed 16 September 2024)
Training Modules on Sexual and Reproductive Health in Emergencies: An Introduction to the Minimum Initial Service Package (MISP) for Sexual and Reproductive Health (SRH), by IPPF with IAWG, 2023. Available at: https://iawg.net/resources/ippf-training-modules-misp (Accessed 15 September 2024)
Introduction to the Emergency Response Framework (ERF), Offered by OpenWHO. Available at: https://openwho.org/courses/ERF?tracking_user=2Ix8RTrYckmYvFRSnpbi8n&tracking_type=news&tracking_id=2X9rl6gcD56gG4ambgnrZ&mc_cid=0c2adf3aeb&mc_eid=7d6fd5ab86 (Accessed 16 September 2024)
Further readings:
MATERNAL AND NEWBORN HEALTH DURING INFECTIOUS DISEASE OUTBREAKS, Operational Guidance for Humanitarian and Fragile Settings, Ready Initiative, 2023. Available at: https://www.ready-initiative.org/wp-content/uploads/2023/04/READY-MNH-Guidance-Feb-2023-Final-opt.pdf (Accessed 16 September 2024)
A The Johns Hopkins and Red Cross / Red Crescent PUBLIC HEALTH GUIDE FOR EMERGENCIES. Available at: https://pdf.usaid.gov/pdf_docs/pnacu086.pdf (Accessed 16 September 2024)
Addressing Gender-Based Violence Across Contexts: Gender-Based Violence Interagency Minimum Standards and the Essential Services Package for Women and Girls Subject to Violence, UNFPA, 2022. Available at: https://www.unfpa.org/publications/addressing-gender-based-violence-across-contexts-gender-based-violence-interagency?mc_cid=b56cb12884&mc_eid=7d6fd5ab86 (Accessed 16 September 2024)