Background: The continuing conflict in Iraq has now created an estimated four million internally displaced persons (IDPs). The bulk of recently displaced persons are in Central Iraq, often in insecure and difficult situations.

Objective: To determine the health status and health needs of women and children, age 15 and under, among a sample of this IDP population in Kirkuk, Baghdad, and Karbala governorates.

Methods: Data were collected from the senior female in 1216 families which contained 3665 children living in 45 makeshift settlements.

Findings: The majority of IDPs were living in tents or religious centers. Repeated displacements were common. Kidnappings were reported by 5.2% of families, and 7.9% of families reported a death of a family member during or after displacement. Intentional violence accounted for 72.3% of deaths. Only a third of children in school at the time of displacement continued in school. On average, households had received assistance on 3.2 occasions since displacement, food being the most common form. Access to health services was difficult. Some form of transport was often required. Few women knew where to secure antenatal services and many did not know where childhood immunization services were available. During or after displacement 307 women had delivered or were currently pregnant. Complications of pregnancies were common, with a quarter reporting anemia, and 22.1% experiencing hemorrhage. Both communicable and non-communicable diseases (NCDs) were common in the women and children in the survey. Scabies, diarrhea and lice were common among children. Among women, hypertension accounted for 36.6% of NCDs and type 2 diabetes for 15.9%. Domestic violence directed against women was reported in 17.4% of families and against children in 26.6%

Interpretation: Women and children in IDP settlements of Central Iraq experience many vulnerabilities involving their health, education and their environment, in addition to living in physical danger. While some external assistance was received, much more is needed to meet the needs of a displaced population which is unlikely to return home soon.

Background: Gender based violence (GBV) remains one of the most serious threats to the health and safety of women and girls worldwide. The problem is even more pronounced in refugee populations where women and girls are at increased risk of violence. In 2015, UNHCR reported the highest number of forcibly displaced people in recorded history. Despite growing need, there have been few rigorous evaluations of interventions aimed at primary GBV prevention and no systematic reviews of GBV prevention efforts specifically focused on refugee populations; reviews to date have primarily examined prevention of conflict related sexual violence, with very limited focus on other forms of GBV such as intimate partner violence

Methods: This study reviewed the scientific literature addressing strategies for primary prevention of GBV and their effectiveness among refugee populations over the past ten years (2006 to 2015). Narrative content analysis methods were used to extract findings related to prevention activities/programs recommended by the global humanitarian community, such as sociocultural norms change, rebuilding family and community support structures, improving accountability systems, designing effective services and facilities, working with formal and traditional legal systems, monitoring and documenting GBV, and/or engaging men and boys in GBV prevention and response.

Results: Study findings indicate that a range of GBV prevention activities recommended by the global humanitarian community are currently being applied in a variety of settings. However, there remains a limited body of evidence on the effectiveness of GBV prevention programs, interventions, and strategies, especially among refugee populations.

Conclusion: Commonly agreed upon standards or guidelines for evaluation of GBV prevention programming, and publication of evaluations conducted using these guidelines, could assist humanitarian stakeholders to build and disseminate an evidence base of effective GBV prevention interventions, programs and strategies. Evaluation of GBV prevention efforts, especially among refugee populations, must be given higher priority to justify continuation or revision of recommended GBV activities/programs being implemented in diverse humanitarian settings.

Introduction: Iran is placed among countries suffering from the highest number of earthquake casualties. Household preparedness, as one component of risk reduction efforts, is often supported in quake-prone areas. In Iran, lack of a valid and reliable household preparedness tool was reported by previous disaster studies. This study is aimed to fill this gap by developing a valid and reliable tool for assessing household preparedness in the event of an earthquake.

Methods: This survey was conducted through three phases including literature review and focus group discussions with the participation of eight key informants, validity measurements and reliability measurements. Field investigation was completed with the participation of 450 households within three provinces of Iran. Content validity, construct validity, the use of factor analysis; internal consistency using Cronbach’s alpha coefficient, and test-retest reliability were carried out to develop the tool.

Results: Based on the CVIs, ranging from 0.80 to 0.100, and exploratory factor analysis with factor loading of more than 0.5, all items were valid. The amount of Cronbach’s alpha (0.7) and test-retest examination by Spearman correlations indicated that the scale was also reliable. The final instrument consisted of six categories and 18 questions including actions at the time of earthquakes, nonstructural safety, structural safety, hazard map, communications, drill, and safety skills.

Conclusion: Using a Persian-version tool that is adjusted to the socio-cultural determinants and native language may result in more trustful information on earthquake preparedness. It is suggested that disaster managers and researchers apply this tool in their future household preparedness projects. Further research is needed to make effective policies and plans for transforming preparedness knowledge into behavior.

Introduction: Sudden impact disasters often result in the displacement of large numbers of people. These movements can occur prior to events, due to early warning messages, or take place post-event due to damages to shelters and livelihoods as well as a result of long-term reconstruction efforts. Displaced populations are especially vulnerable and often in need of support. However, timely and accurate data on the numbers and destinations of displaced populations are extremely challenging to collect across temporal and spatial scales, especially in the aftermath of disasters. Mobile phone call detail records were shown to be a valid data source for estimates of population movements after the 2010 Haiti earthquake, but their potential to provide near real-time ongoing measurements of population displacements immediately after a natural disaster has not been demonstrated.

Methods: A computational architecture and analytical capacity were rapidly deployed within nine days of the Nepal earthquake of 25th April 2015, to provide spatiotemporally detailed estimates of population displacements from call detail records based on movements of 12 million de-identified mobile phones users.

Results: Analysis shows the evolution of population mobility patterns after the earthquake and the patterns of return to affected areas, at a high level of detail. Particularly notable is the movement of an estimated 390,000 people above normal from the Kathmandu valley after the earthquake, with most people moving to surrounding areas and the highly-populated areas in the central southern area of Nepal.

Discussion: This analysis provides an unprecedented level of information about human movement after a natural disaster, provided within a very short timeframe after the earthquake occurred. The patterns revealed using this method are almost impossible to find through other methods, and are of great interest to humanitarian agencies.

Introduction: In anticipation of Hurricane Sandy in 2012 New York City officials issued mandatory evacuation orders for evacuation Zone A. However, only a small proportion of residents complied. Failure to comply with evacuation warnings can result in severe consequences including injury and death. To better ascertain why individuals failed to heed pre­-emptive evacuation warnings for Hurricane Sandy we assessed factors that may have affected evacuation among residents in neighborhoods severely affected by the storm.

Methods: Data from a mental health needs assessment survey conducted among adult residents in South Brooklyn, the Rockaways, and Staten Island from December 13-­18, 2012 was assessed. Several disasters related questions were evaluated, and prevalence estimates of evacuation and evacuation timing by potential factors that may influence evacuation were estimated. Measures of association were assessed using chi-­square and t-­test.

Results: Our sample consisted of 420 residents of which, only 49% evacuated at any time for Sandy. Evacuation was higher among those who witnessed trauma to others related to the World Trade Center attacks (66% vs. 40%, p=0.024). Those who reported extensive household damage after Sandy, had a higher rate of evacuation than those with minimal damage (83% vs. 30%, p<0.001). Among those who evacuated, evacuation before the storm was lower among residents living on higher floors (56% vs. 22%, p=0.022).

Discussion: Given that warnings to evacuate were issued before Sandy made landfall, evacuation among residents in South Brooklyn, the Rockaways and Staten Island, while higher than the overall Zone A evacuation rate, was less than optimal. Continued research on evacuation behaviors is needed, particularly on how timing affects evacuation. A better understanding may help to reduce barriers, and improve evacuation compliance.

Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon.

Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis.

Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the pregnant woman cooperated with others for survival and used their knowledge of disease prevention.

Discussion: Pregnant women experienced difficulties with evacuation, a lack of minimum survival needs, and attending to their own health issues. Pregnant women were also concerned about needs and health issues of their families, particular, when they had small children. Collecting accurate information regarding the disaster and conducting self-sustainable preparation prior to the disaster among pregnant women will help them to protect their pregnancy status, thereby improving their families’ chance of survival during and after disasters.

Background: Tehran is vulnerable to natural hazards, especially earthquakes. Disaster preparedness behaviors (DPB) are measures that can mitigate the adverse consequences of disasters. Demographic factors affect DPB, however, the role of some of these factors is not still clear. By understanding these effects, disaster specialists could design interventions toward specific demographics. In the present study, we aimed to investigate demographic determinants of DPB.

Methods: This cross-sectional survey was conducted in August 2014. The target population included inhabitants of Tehran who were 18 years or older. A total of 1250 participants were selected randomly and interviewed using a standardized questionnaire.

Results: Results of our study showed that monthly income level, previous disaster experience, residential district and occupation are demographic factors that influence DPB significantly. However, disaster preparedness was not affected by gender, educational level, number of household members, home type, home ownership and being the head of household.

Conclusion: To promote DPB in Tehran, disaster specialists should focus on improving DPB in low-income and unemployed people, and individuals who live in high risk districts, especially in those who have not experienced disasters.

Key words: Disaster, Preparedness behavior, Demographic determinants.