**1. Introduction**

Humanitarian health has been suggested as a key research priority and an essential part of global health initiatives in emergencies [1]. In 2020, nearly 168 million people worldwide are estimated to be in need of assistance or protection due to humanitarian emergencies, such as conflicts or natural disasters [2]. Needs assessment is one of the fundamental cores of the humanitarian health response, both in long-lasting humanitarian settings and after sudden-onset disasters. A proper and well-designed needs assessment lays the foundation for a coherent, efficient and trustworthy humanitarian response to any emergency [3]. Many of the humanitarian emergencies are long-lasting crises, and the majority of all people considered as affected by humanitarian emergencies live in designated areas, such as camps [3]. Health and well-being among people living in such camps include a wide range of potential health problems: infectious diseases, chronic conditions, injuries, malnutrition, gender-based violence, mental health problems and disruption of cultural and social conventions [4]. The daily life of affected people living in camps is fraught with unmet basic needs [5]. Having a higher level of perceived needs has been found to predict a greater level of psychological distress [6]. Therefore, a reliable

**Citation:** Hugelius, K.; Nandain, C.; Semrau, M.; Holmefur, M. The Reliability and Feasibility of the HESPER Web to Assess Perceived Needs in a Population Affected by a Humanitarian Emergency. *Int. J. Environ. Res. Public Health* **2021**, *18*, 1399. https://doi.org/10.3390/ ijerph18041399

Academic Editors: Lillian Mwanri, Hailay Gesesew, Nelsensius Klau Fauk and William Mude Received: 10 January 2021 Accepted: 1 February 2021 Published: 3 February 2021

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assessment of perceived needs can be said to be the fundament in order to understand mental health and other health problems among people in vulnerable situations [7].

The development and availability of scientifically and contextual feasible instruments to assess health and needs in humanitarian emergencies is strongly needed [1]. The Humanitarian Emergency Settings Perceived Needs (HESPER) scale was developed to provide a quick and reliable way to assess the perceived needs of affected people in humanitarian emergencies, including complex emergencies, conflicts and natural disasters [8]. The HES-PER scale was developed by the World Health Organization and Institute of Psychiatry at King's College London, based on literature studies, experts on humanitarian assessments and several pilot- and field tests including different samples of populations affected by different kinds of humanitarian emergencies. A detailed description of the development and testing of the scale has been reported elsewhere [8]. The original HESPER was designed to gather data through individual face-to-face interviews and paper surveys. Today, an increasing part of the world population has access to Internet connections. About 93% of all displaced people in the world have access to a mobile network, and many have access to the Internet, through a mobile connection, broadband in schools, community Internet cafés or other sources. Additionally, in rural areas, the coverage and quality are progressively improving [9]. Internet-based data gathering offers quicker data collection and analysis and fewer internal dropouts and processing errors, and is often a more economical alternative to other types of surveys [10]. To combine the strengths of Internet-based data collections and a scale measuring perceived needs among humanitarian populations, we developed HESPER Web, a self-administrated web-based version of the original HESPER [11]. The HESPER Web can be administrated through a web link and answered on a computer, tablet or mobile phone and the first psychometric evaluation of HESPER Web showed very good reliability and feasibility among a study sample of asylum seekers in Sweden [11]. In order to further evaluate the HESPER Web, a field test in a large scale humanitarian context was necessary.

This study had three aims; (1) to evaluate the reliability and feasibility of HESPER Web in a large-scale humanitarian context, (2) to compare the demographics and means of the perceived needs of a random walk method study sample and a convenient, self-selected study sample recruited though social media and (3) to describe the perceived needs within the study sample.
