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Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation

机译：评估复杂紧急情况下的健康，营养和粮食安全计划：以刚果为例，说明冲突后的长期状况

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OBJECTIVE: To describe the case of Congo as an example of the assessment and appropriateness of donor operational and sectoral strategies in a complex emergency. DESIGN AND SETTING: The paper reports the findings of an external evaluation of operations financed by the European Commission Humanitarian Office in the Democratic Republic of Congo (DRC). RESULTS: The Congolese health system is suffering from severe deterioration. What is functioning in the public health context is donor-dependent with high costs and limited coverage. Despite a relatively favourable agro-climatic situation, food shortage and famine severely affect the nutritional status of large population groups. In this context, humanitarian programmes have generally improved access to health care and the nutritional status of beneficiaries. The reduction of malnutrition in project areas is often demonstrated even though the context did not permit consolidation of these results. Malnutrition continues to claim a massive cost of lives owing to the effect of widespread food insecurity that follows a circular cause-and-effect pattern of very low food production and extreme poverty. CONCLUSIONS: The current context in DRC does not correspond yet to 'post-crisis': neither at population level with regard to indicators of poverty, malnutrition, disease and death, nor at institutional level, with regard to state support to institutions. In these situations, the international community is often called upon to replace the state as service provider. Integrated humanitarian actions should be the future of relief projects in DRC. Health, nutrition and food security components should be considered a standard public health intervention strategy representing the most sensible approach to address the needs of the affected population.
机译：目的：以刚果为例，说明在复杂的紧急情况下对捐助者的业务和部门战略的评估和适当性。设计与环境：本文报告了对由刚果民主共和国欧洲委员会人道主义事务办公室资助的行动进行外部评估的结果。结果：刚果卫生系统正在严重恶化。在公共卫生方面起作用的是依赖捐助者的，费用高且覆盖面有限。尽管农业气候条件相对有利，但粮食短缺和饥荒严重影响了大批人口的营养状况。在这种情况下，人道主义方案总体上改善了获得保健和受益人营养状况的机会。即使情况不允许合并这些结果，也经常证明项目地区的营养不良有所减少。由于普遍的粮食不安全所造成的后果，营养不良继续造成巨大的生命损失，而粮食不安全是一种循环的因果关系，即粮食产量极低和极端贫困。结论：刚果民主共和国目前的情况还不符合“危机后”：在贫困，营养不良，疾病和死亡指标方面，无论是在人口一级，还是在国家对机构的支持方面，在机构一级都没有。在这种情况下，国际社会经常被要求取代国家作为服务提供者。人道主义综合行动应该是刚果民主共和国救济项目的未来。应当将卫生，营养和粮食安全组成部分视为标准的公共卫生干预策略，这是解决受影响人口需求的最明智方法。

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