IPC Classification in areas with limited or no humanitarian access - Special additional protocols

The IPC analysis is also needed in situations where limited access prevents humanitarian organizations from collecting suitable evidence. For classification of areas with limited or no humanitarian access, where IPC standard data requirements cannot be met, classification can still be completed provided that the additional specific protocols are followed for each function.

Limited humanitarian access refers to those areas to which access to collect evidence is either non-existent or very restricted, usually due to conflict or a major natural disaster. 

Function 1: Build Technical Consensus

When analyses are to be carried out in areas with limited or no humanitarian access, it is imperative that the analysis team also include people who have an in-depth understanding of the context. As much as possible, key analysts should participate in data collection exercises and bring their expert assessment to the analysis. 

Function 2: Classify Severity and Identify Key Drivers

  • R0 evidence can be used to support the IPC analysis, provided it follows the parameters stipulated in Box 104.
  • A combination of sources of evidence should be used to the extent possible (e.g. data collected during a helicopter mission to an area affected by conflict, assessment of new arrivals by area of residence and travel time, evidence from similar nearby areas, historical trend analysis, evidence from distribution points).
  • Minimum evidence level includes at least GAM based on MUAC with R0 evidence as detailed in Table 45.
  • The number of children with acute malnutrition may be estimated through GAM based on MUAC estimates and used as working estimates to determine the response required.
  • Time validity of the analysis should be short, and projection updates are not allowed.

Box 104. Classifications of areas with limited or no humanitarian access

Guidance for data collection in areas with no or limited humanitarian access (note: this evidence can score a R0) reliability

Validity of rapid ad hoc methods:

  • Estimates should reflect an overview of the overall malnutrition situation given the limited window of opportunity to collect data and conduct some observations (usually hours).
  • Methods may include rapid and non-representative assessments carried out in small geographical areas such as villages and camps. Results of rapid assessments are only applicable to the assessment area or to similar areas (e.g. estimates from an IDP camp may be used to infer the situation in other similar camps provided that expert knowledge and other evidence indicates similarity between camps).
  • Results from several of these small geographical units may be used to express the situation in a larger geographical area such as district and county if at least three clusters are surveyed in the target area.
  • The type of malnutrition that is of concern in these types of conditions is Acute Malnutrition, which is assessed through MUAC screening. If possible, oedema should also be checked.
  • In general, data collection should involve collecting information from as many individuals as possible following as many different simultaneous approaches.
  • The sample should be optimally selected either exhaustively or randomly. If possible, the sample should include interviews/measurements at a central place and through residences. Estimates made at the intervention points (e.g. food distribution points, health care admission screening points) should be contextualized due to known selection bias and used together with evidence from community screening.
  • If data come from both household and central point screening, merging them may not be valid. Each sample should be described separately, and then the best estimate produced by understanding the selection biases of both samples; this may require advanced analytical skills and a clear understanding of actions/activities on the ground and how they were implemented.
  • With respect to mortality assessments, the type of mortality that is of interest is CDR. A mix of qualitative and quantitative methods such as interviews with key informants, grave counting and a review of hospital or health centre records is used.
  • The approach to sample design and selection can be ad hoc since it uses the opportunities on the ground to quickly access subjects (such as distribution campaigns, health clinic services, available key informants) and may include measuring anthropometric indicators in non-conventional target groups, such as adults rather than children. When using these types of approaches to sampling, the limitations, potential biases or restricted conclusions should be clearly indicated.
  • Anthropometric measurements of new arrivals to neighbouring areas can provide evidence on the likely conditions of their place of origin if information on the length of journey is considered to ensure that the condition of those newly arrived can inform the conditions expected in those inaccessible areas.
  • The IPC guidelines provide only basic guidance, and the methods may need to be adapted to the situation on the ground. It is absolutely critical to thoroughly document the methods and procedures used for data collection in this situation to clearly understand possible limitations and selection biases of the sampling methods used. It is crucial to thoroughly document all activity in the community (e.g. distributions, vaccination, health clinic activities and access) and to exhaustively describe the activities that were carried out during the assessment, including why and how they were carried out.
  • An external IPC quality review needs to be conducted for all classifications in areas with limited humanitarian access that did not receive external support during the analysis. A Famine Review should be conducted if analysts suspect famine in these areas.

Time relevance:

  • Given the high volatility of areas with limited or no humanitarian access, current classifications should be based on data collected within the previous three to five months of classification, and not necessarily from the same season of analysis.
  • Evidence collected during times when estimates are expected to be different from current time (either because of seasonality or negative shocks) should be extrapolated to their potential current values.

Function 3: Communicate for Action

  • Communications should clearly highlight the fact that the area was classified with reduced evidence due to difficult humanitarian access; specific mapping protocols should be used.

Function 4: Quality Assurance

  • An external quality review needs to be conducted when evidence is reduced due to limited or no humanitarian access and the analysis team did not receive external support from the Global Support Unit. See Function 4 under IPC Acute Malnutrition protocols for details on external quality reviews.