Research Article: Documenting Mortality in Crises: What Keeps Us from Doing Better?

Date Published: July 1, 2008

Publisher: Public Library of Science

Author(s): Francesco Checchi, Les Roberts

Abstract: Francesco Checchi and Les Roberts discuss how mortality among crisis-affected populations is currently documented, barriers to better documentation, and how these barriers might be overcome.

Partial Text: This is the second in a series of articles on conducting research during complex humanitarian emergencies. The first is at PLoS Med 5(4): e89. doi:10.1371/journal.pmed.0050089

How many of the more than 3 million estimated to have died in the DRC because of war [28] might still be alive if credible, crisis-wide mortality estimates had become available sooner, and been used to inform policy? The establishment of a technical, apolitical body dedicated to timely, systematic collection of valid mortality data, especially in the least funded and publicised crises, could help to ensure that the DRC experience is not repeated. Such a body could also independently evaluate mortality study protocols and reports, promote best-practice methods, and train a cadre of researchers to be deployed to emergent crises. Such a body could constitute a resource for relief agencies and improve the quality of press coverage and discussion around ongoing crises. The fledgling Health and Nutrition Tracking Service [79], currently hosted by WHO, proposes to coordinate some of the above tasks. If housed within a UN agency or government, its effectiveness might be stymied by negotiations between UN headquarters, the UN country office, and the host government. Whatever its positioning (we suggest autonomy from all existing institutions; Spiegel proposes ad hoc bodies for each crisis [18]), its independence will be a key success determinant, and could be fostered through the following measures: (1) non-earmarked, long-term funding by a very broad spectrum of donors, with preference for politically neutral ones; (2) ability to pursue projects without consulting donors; (3) involvement of experts based on technical merit alone; and (4) independent review by a contracted firm and/or representatives from civil society, especially from crisis-affected populations. The monitoring of war prisoners by the International Committee of the Red Cross could serve as a model.



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