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Introduction
The past 10 years have seen a significant increase in the amount of resources allocated to public health programmes for refugees.1 Increased funding and complex challenges in providing effective public health interventions in refugee settings have brought associated demands for better data and improved accountability.
In the past five years, the Office of the United Nations High Commissioner for Refugees (UNHCR) and its partners have developed and implemented a standardized health information system (HIS) in numerous countries to monitor camp-based refugee health programmes.2 The aim has been to improve the health status of refugees and other displaced persons through evidence-based policy formulation and better management of health programmes. At the end of 2009, a total of 17 operations in Africa, Asia and the Middle East were reporting into a standardized HIS using common tools and guidelines. The total population under surveillance was approximately 1.5 million refugees in 85 refugee camps across 24 different partners.
The introduction of standardized data collection and reporting tools into refugee camps, and the increased availability and accessibility of data to decision-makers, has brought with it several advantages. However, it has also raised important questions, the most fundamental of which is: how should a refugee HIS work alongside its much larger national equivalent within the ministry of health?
This paper discusses the rationale for establishing a refugee HIS in countries that host camp-based refugee populations. It attempts to dispel a common misconception that refugee and national HIS are two competing and incompatible alternatives. Instead it describes how a refugee HIS can be used to support data management within host government systems.
Need for data
A strong evidence-base exists to document the public health challenges faced by refugees and the need to establish strong information systems in displacement settings.3,4 However, there has been little documentation of the reasons that refugee health data are of public health importance to national governments, or how refugee information systems should relate to their national equivalents. Some of the most significant reasons that explain the need for refugee data are described here.
Disease surveillance and outbreaks
The geographic location of refugee camps, often close to international borders, places them at greater risk of cross-border transmission and outbreaks of epidemic-prone disease. Therefore, disease surveillance within refugee camps...