Effectiveness of Emergency Response Efforts

One of the primary challenges in a large-scale response to a public health emergency is measuring the effectiveness of external actors attempting to provide assistance to the population affected by the disaster.  Although almost all the players have altruistic intentions, each organization still possesses certain objectives or motives that need to be met.  Essentially, they each need to prove the organization's effectiveness in meeting the needs of disaster victims.  Professionalism has entered the domain of Non-Governmental Organizations (NGOs) (American Red Cross), bilateral government donor agencies (USAID), and the UN.  Historically, these aid and response agencies have had minimal oversight and plenty of funding.  Good intentions were not always met with good outcomes.  Donors have become more savvy, and they are now requiring information and data on organizational effectiveness when intervening in a disaster situation.  People who contribute $10 or foundations that donate $1,000,000 all want to know if their money was well spent.  Two of the main areas for evaluation are outputs and outcomes.

• Outputs are "quantitative" measurable data.  How many blankets were distributed? How many meals were provided? How many injuries were treated?  These data are usually quantifiable with specific numbers, and they are easy to present to the public.  
• Outcomes are "qualitative" data and frequently more difficult to measure.  This data usually comes from focus groups or interviews with disaster victims.  They are often descriptive and narrative rather than measurable.  They often focus on satisfaction, perceptions, awareness.

What are the challenges to monitoring and evaluating response to disasters?

• Who will do the "counting?" 
• How do you "measure" during a crisis (possibly diverting time and efforts away from delivery of aid)? 
• What will be the universally recognized indicators?

Disasters and emergency situations are complex environments, and multiple expectations exist.  The affected people expect (and deserve) immediate and life-saving assistance.  The donors expect cost-effectiveness for their donations.  The aid agencies expect to "get the job done" so they can be invited back and continue to have longevity.