ease-specific, questions remain on the operational and organizational structure of health delivery in complex emergencies. The Sphere Project is an important step in addressing some of these operational issues by setting minimum standards. The application of IMCI guidelines or other comprehensive guidelines will involve addressing resource constraints and operational issues in various situations. Sharing lessons learned in the field on the application of clinical, preventive, and health systems guidelines will remain central to the goal of reducing morbidity and mortality among children in complex emergencies.


For helpful discussions and assistance we thank Richard Allen, Myron Belfer, Claudio Beltramello, Paul Bolton, Rayana Bu-Hakah, Gilbert Burnham, Manuel Carballo, Marie Connolly, Michelle Gayer, Elizabeth Hunt, Walt Jones, Sultana Khanum, Lianne Kuppens, Thomas Nierle, Agostino Paganini, Pierre Perrin, Anastasia Pharris-Ciurej, Elizabeth Rowley, R. Bradley Sack, Hakan Sandbladh, Paul Spiegel, Ronald Waldman, and the participants of the WHO-UNICEF Workshop on Child Health in Complex Emergencies held in Geneva 21-22 October 2003. We are especially grateful to the organizations that kindly responded to our surveys (Appendix A).

This work was supported by a grant from the Department of Child and Adolescent Health and Development of WHO to the Center for International Emergency, Disaster and Refugee Studies (CIEDRS; now the Center for Refugee and Disaster Response) at the Johns Hopkins Bloomberg School of Public Health.

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