Intended for healthcare professionals

Education And Debate

Raising standards in emergency relief: how useful are Sphere minimum standards for humanitarian assistance?

BMJ 2001; 323 doi: (Published 29 September 2001) Cite this as: BMJ 2001;323:740
  1. Griekspoor André, head of the monitoring and evaluation unit (,
  2. Steve Collins, directorb
  1. a Médecins Sans Frontières, Amsterdam, Netherlands
  2. b Valid International, Oleuffynon, Llanidloes, Powys SY18 6PJ
  1. Correspondence to: A Griekspoor, 148 Impasse du Saugy, 01210 Ornex, France
  • Accepted 18 June 2001

International humanitarian agencies have recently developed a set of standards governing the implementation of relief programmes.1 The Sphere standards were developed in response to concerns about the quality and impact of humanitarian assistance and are analogous to those set for healthcare services in developed countries. 2 3 Although the standards have been generally welcomed, concerns have been raised about their use. 4 5 One worry is that the main measures apply only to ideal situations in relief camps and that standardisation will prevent relief workers from adapting in more complex situations. Another fear is that politicians could use the standards to obscure their responsibilities to tackle the underlying causes of emergencies. Finally, the indicators could foster unrealistic expectations while ignoring constraints. This could lead to unjustified adverse publicity, liability, and reprisals. 6 7 In this article we describe the standards and assess their usefulness by considering the application of nutritional standards in the 1998 famine in Sudan.

Summary points

In January 2000, the Sphere project published the first handbook describing minimum standards and related key indicators applicable to emergency relief programmes

The handbook aims to stimulate learning and accountability by measuring process and outcome

The standards and key indicators are minimum values for beneficiaries but cannot always be used as planning objectives by humanitarian agencies

Assessment of performance of single agencies must take into account the general context of the emergency, particularly resource availability, access, and interventions by others

Use of technical standards must be accompanied by an obligation on states to respond to humanitarian emergencies and guarantee the rights of populations

Development of standards

The Sphere project is a consortium of the international humanitarian community set up to establish what is technically and normally possible for relief operations.8 More than 700 people from 228 relief organisations in 60 countries considered ideas on …

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