Skip to main content
×
Home

Community Health Workers and Disasters: Lessons Learned from the 2015 Earthquake in Nepal

  • Karla Fredricks (a1) (a2), Hao Dinh (a1), Manita Kusi (a3), Chandra Yogal (a3), Biraj M. Karmacharya (a3) (a4), Thomas F. Burke (a1) (a2) (a5) and Brett D. Nelson (a1) (a2) (a5)...
Abstract
Abstract Introduction

The Nepal earthquake of 2015 was a major disaster that exacted an enormous toll on human lives and caused extensive damage to the infrastructure of the region. Similar to other developing countries, Nepal has a network of community health workers (CHWs; known as female community health volunteers [FCHVs]) that was in place prior to the earthquake and continues to function to improve maternal and child health. These FCHVs and other community members were responsible, by default, for providing the first wave of assistance after the earthquake.

Hypothesis/Problem

Community health workers such as FCHVs could be used to provide formal relief services in the event of an emergency, but there is a paucity of evidence-based literature on how to best utilize them in disaster risk reduction, preparedness, and response. Data are needed to further characterize the roles that this cadre has played in past disasters and what strategies can be implemented to better incorporate them into future emergency management.

Methods

In March 2016, key-informant interviews, FCHV interviews, and focus group discussions (FGDs) were conducted in Nepali health facilities using semi-structured guides. The audio-recorded data were obtained with the assistance of a translator (Nepali-English), transcribed verbatim in English, and coded by two independent researchers (manually and with NVivo 11 Pro software [QSR International; Melbourne, Australia]).

Results

Across seven different regions, 14 interviews with FCHVs, two FGDs with community women, and three key-informant interviews were conducted. Four major themes emerged around the topic of FCHVs and the 2015 earthquake: (1) community care and rapport between FCHVs and local residents; (2) emergency response of FCHVs in the immediate aftermath of the earthquake; (3) training requested to improve the FCHVs’ ability to manage disasters; and (4) interaction with relief organizations and how to create collaborations that provide aid relief more effectively.

Conclusions

The FCHVs in Nepal provided multiple services to their communities in the aftermath of the earthquake, largely without any specific training or instruction. Proper preparation, in addition to improved collaboration with aid agencies, could increase the capacity of FCHVs to respond in the event of a future disaster. The information gained from this study of the FCHV experience in the Nepal earthquake could be used to inform risk reduction and emergency management policies for CHWs in various settings worldwide.

Fredricks K , Dinh H , Kusi M , Yogal C , Karmacharya BM , Burke TF , Nelson BD . Community Health Workers and Disasters: Lessons Learned from the 2015 Earthquake in Nepal. Prehosp Disaster Med. 2017;32(6):604609.

Copyright
Corresponding author
Correspondence: Karla Fredricks, MD, MPH Division of Global Health and Human Rights Department of Emergency Medicine Massachusetts General Hospital E-mail: karla.fredricks@gmail.com
Footnotes
Hide All

Conflicts of interest: none

Footnotes
References
Hide All
1. Government of Nepal. Incident Report of Earthquake 2015. http://drrportal.gov.np. Accessed October 1, 2016.
2. Noji EK. Public health issues in disasters. Crit Care Med. 2005;33(1 Suppl):S29.
3. World Health Organization. Global Health Workforce Statistics database. Updated 2014. http://www.who.int/hrh/statistics/hwfstats/. Accessed October 1, 2016.
4. Nicholls K, Picou JS, Curtis J, Lowman JA. The utility of community health workers in disaster preparedness, recovery, and resiliency. Journal of Applied Social Science. 2015;9(2):191.
5. Miyaguchi M, Yasuoka J, Poudyal AK, Silwal RC, Jimba M. Female community health volunteers service utilization for childhood illness- improving quality of health services only is not enough: a cross-sectional study in mid-western region, Nepal. BMC Health Serv Res. 2014;14:383.
6. Schwarz D, Sharma R, Bashyal C, et al. Strengthening Nepal’s female community health volunteer network: a qualitative study of experiences at two years. BMC Health Serv Res. 2014;14:473.
7. Schensul SL, Schensul JJ, LeCompte MD. Essential Ethnographic Methods: Observations, Interviews, and Questionnaires (Ethnographer’s Toolkit). Volume 2. Walnut Creek, California USA: AltaMira Press; 1999: 240.
8. Devers KJ, Frankel KM. Study design in qualitative research—2: sampling and data collection strategies. Educ Health. 2000;13(2):263.
9. Global Health Workforce Alliance, WHO, IFRC, UNICEF, UNHCR. Scaling-up the Community-Based Health Workforce for Emergencies: Joint Statement by the Global Health Workforce Alliance, WHO, IFRC, UNICEF, UNHCR. Published 2011. http://www.unicef.org/media/files/Scaling-up_community-based_health.pdf. Accessed October 1, 2016.
10. United Nations International Strategy for Disaster Reduction. Hyogo Framework for Action 2005–2015: Building the resilience of nations and communities to disasters. Published 2005. http://www.unisdr.org/2005/wcdr/intergover/official-doc/L-docs/Hyogo-framework-for-action-english.pdf. Accessed October 1, 2016.
11. United Nations International Strategy for Disaster Reduction. Sendai Framework for Disaster Risk Reduction 2015–2030. Published 2015. http://www.unisdr.org/files/43291_sendaiframeworkfordrren.pdf. Accessed October 1, 2016.
12. World Health Organization. World Health Assembly Resolution 64.10. Published 2011. http://apps.who.int/iris/bitstream/10665/3566/1/A64_R10-en.pdf. Accessed October 1, 2016.
13. Adhikari B, Mishra SR, Raut S. Rebuilding earthquake struck Nepal through community engagement. Front Public Health. 2016;4:121.
14. World Health Organization, Regional Committee for Africa. Disaster risk management: a strategy for the health sector in the African region. Report of the Secretariat. Published 2012. http://www.afro.who.int/en/downloads/cat_view/1501-english/2210-meetings-and-events/861-regional-committee/2065-sixty-second-session-of-the-who-regional-committee-for-africa/2066-english/2074-resolutions.html. Accessed October 1, 2016.
15. Olu O, Usman A, Manga L, et al. Strengthening health disaster risk management in Africa: multi-sectoral and people-centered approaches are required in the post-Hyogo Framework of Action era. BMC Public Health. 2016;16:691.
16. Bayntun C. A health system approach to all-hazards disaster management: a systematic review. PLOS Curr. 2012;1.
17. Campbell F, Shafique M, Sansom P. Responding to Cyclone Nargis: key lessons from Merlin’s experience. Humanitarian Practice Network. Published 2008. http://odihpn.org/magazine/responding-to-cyclone-nargis-key-lessons-from-merlin%C2%92s-experience/. Accessed October 1, 2016.
18. United Nations Children’s Fund. In Pakistan’s flood-devastated Sindh province, female health workers play key role. Published 2010. http://www.unicef.org/infobycountry/pakistan_56039.html. Accessed October 1, 2016.
19. Hung KKC, Otsu S. Community Health Workers Prove the Key to Philippines Relief Efforts. EPi Journal. Published 2014. http://www.epijournal.com/articles/122/community-health-workers-prove-the-key-to-philippines-relief-efforts. Accessed October 1, 2016.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
WORD
Supplementary Materials

Fredricks supplementary material
Appendix

 Word (18 KB)
18 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 2
Total number of PDF views: 40 *
Loading metrics...

Abstract views

Total abstract views: 264 *
Loading metrics...

* Views captured on Cambridge Core between 8th August 2017 - 11th December 2017. This data will be updated every 24 hours.