3.3.1 Health policies and systems

The host country’s Ministry of Health (MOH) should lead the health sector response to any emergency, where possible. International assistance and resources should support the local MOH infrastructure and human capacity to assist with the extra burden of patients, and to repair damage to the health system and infrastructure caused by the emergency. When the MOH lacks the capacity to assume the leadership role of the health sector, a UN or other agency will often take on the responsibility for a temporary period of time.

All assistance provided by international NGOs should be provided in line with national health policies and systems. In cases where the health policies and systems are inadequate or have been destroyed due to the crisis (for example, in complex humanitarian emergencies characterised by state failure), international recovery and assistance efforts may include support to re-establish basic policies, systems and infrastructure, based on international best practices on the specific specialist areas of care.

The following key principles should be kept in mind when supporting national health systems:

• Health facility levels that should be considered and reviewed for capacity include a referral hospital, central health facility (health centre), peripheral health facilities (health posts) and home visits.
• These levels of capacity, as well as health standards and guidelines, should fall in line with the host country’s national policies.
• If policies are outdated, the MOH and other organisations supporting health should make revisions based on the most current evidence-based practice as shared by the Health Cluster and harmonizing with other existing internationally accepted guidelines.
• It is preferable that local staff and facilities should be used.
• Fees and lack of infrastructure such as laboratories, referral systems and other resources should be examined to determine if they hinder access or availability to health services.
• Any changes to any health systems or infrastructure, including upgrades to better accommodate those affected by an emergency, need to be made in collaboration with the MOH.

Local populations close to where response efforts are being made will also be affected, in particular with outbreaks of communicable diseases. It is essential that the local population is not overlooked and decisions about access and services need to be inclusive of the local population, including women and adolescent groups, as they may often have to rely on that same system to treat and prevent illnesses or mortality.