The Value of Joint External Evaluation as a Tool for Country-level Health Security Monitoring

2019 ◽  
Vol 17 (2) ◽  
pp. 166-167
Author(s):  
Adam T. Craig ◽  
Alison R. Sio
2017 ◽  
Vol 5 (9) ◽  
pp. e857-e858 ◽  
Author(s):  
Nirmal Kandel ◽  
Rajesh Sreedharan ◽  
Stella Chungong ◽  
Karen Sliter ◽  
Simo Nikkari ◽  
...  

2019 ◽  
Vol 4 (6) ◽  
pp. e001655 ◽  
Author(s):  
Richard Garfield ◽  
Maureen Bartee ◽  
Landry Ndriko Mayigane

To date more than 100 countries have carried out a Joint External Evaluation (JEE) as part of their Global Health Security programme. The JEE is a detailed effort to assess a country’s capacity to prevent, detect and respond to population health threats in 19 programmatic areas. To date no attempt has been made to determine the validity of these measures. We compare scores and commentary from the JEE in three countries to the strengths and weaknesses identified in the response to a subsequent large-scale outbreak in each of those countries. Relevant indicators were compared qualitatively, and scored as low, medium or in a high level of agreement between the JEE and the outbreak review in each of these three countries. Three reviewers independently reviewed each of the three countries. A high level of correspondence existed between score and text in the JEE and strengths and weaknesses identified in the review of an outbreak. In general, countries responded somewhat better than JEE scores indicated, but this appears to be due in part to JEE-related identification of weaknesses in that area. The improved response in large measure was due to more rapid requests for international assistance in these areas. It thus appears that even before systematic improvements are made in public health infrastructure that the JEE process may assist in improving outcomes in response to major outbreaks.


2020 ◽  
Author(s):  
Brett M. Forshey ◽  
Alexandra K. Woodward ◽  
Jose L. Sanchez ◽  
Stephanie R. Petzing

AbstractMilitaries across the world play an important but at times poorly defined and underappreciated role in global health security. For example, they are often called upon to support civilian authorities in humanitarian crises and to provide routine healthcare for civilians. Furthermore, military personnel are a unique population in a health security context, as they are highly mobile and often deploy to austere settings domestically and internationally, which may increase exposure to infectious diseases. Despite the role of militaries, few studies have systematically evaluated the involvement of militaries in global health security activities, including the Global Health Security Agenda (GHSA). To address this shortcoming, we analyzed Joint External Evaluation (JEE) mission reports (n=91) and National Action Plans for Health Security (n=11) that had been completed as of October 2019 (n=91) to determine the extent to which military organizations have been involved in the evaluation process, country military contributions to health security are accounted for, and specific recommendations are provided for the country’s military. For JEE reports, military involvement was highest for the “Respond” core area (73%) but much lower for the Prevent (36%) and Detect (30%) core areas. Similarly, 73% of NAPHS documents mentioned military involvement in the Respond core area, compared to 27% and 36% for Prevent and Detect, respectively. Additionally, only 26% of JEE reports provide recommendations for the military in any of the core areas. Our results indicate the need to more fully incorporate military roles and contributions into the GHSA framework and other health security activities in order to improve national capabilities to prevent, detect, and respond to infectious disease threats.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050052
Author(s):  
Laura Nguyen ◽  
Morgan Sydney Brown ◽  
Alexia Couture ◽  
Sharanya Krishnan ◽  
Mays Shamout ◽  
...  

ObjectivesThe COVID-19 pandemic has highlighted the importance and complexity of a country’s ability to effectively respond. The Joint External Evaluation (JEE) assessment was launched in 2016 to assess a country’s ability to prevent, detect and respond to public health emergencies. We examined whether JEE indicators could be used to predict a country’s COVID-19 response performance to tailor a country’s support more effectively.DesignFrom April to August 2020, we conducted interviews with Centers for Disease Control and Prevention country offices that requested COVID-19 support and previously completed the JEE (version 1.0). We used an assessment tool, the ‘Emergency Response Capacity Tool’ (ERCT), to assess COVID-19 response performance. We analysed 28 ERCT indicators aligned with eight JEE indicators to assess concordance and discordance using strict agreement and weighted kappa statistics. Generalised estimating equation (GEE) models were used to generate predicted probabilities for ERCT scores using JEE scores as the independent model variable.ResultsTwenty-three countries met inclusion criteria. Of the 163 indicators analysed, 42.3% of JEE and ERCT scores were in agreement (p value=0.02). The JEE indicator with the highest agreement (62%) was ‘Emergency Operations Center (EOC) operating procedures and plans’, while the lowest (16%) was ‘capacity to activate emergency operations’. Findings were consistent with weighted kappa statistics. In the GEE model, EOC operating procedures and plans had the highest predicted probability (0.86), while indicators concerning response strategy and coordination had the lowest (≤0.5).ConclusionsOverall, there was low agreement between JEE scores and COVID-19 response performance, with JEE scores often trending higher. JEE indicators concerning coordination and operations were least predictive of COVID-19 response performance, underscoring the importance of not inferring country response readiness from JEE scores alone. More in-depth country-specific investigations are likely needed to accurately estimate response capacity and tailor countries’ global health security activities.


2020 ◽  
Author(s):  
Viviane Ndoungue Viviane Fossouo ◽  
Mohamed Moctar Mouliom Mouiche ◽  
Christie Tiwoda ◽  
Oumarou Gnigninanjouena ◽  
Serge alain Sadeuh-Mba ◽  
...  

Abstract Objectives: The objective of this study was to present the JEE process in Cameroon’s as well as the country capacities to prevent, detect and respond to public health threats in accordance with the IHR (2005). Data for the 48 indicators within the 19 technical areas of the Joint External Evaluation (JEE) tool was examined. Results: Cameroon's overall median score was 2 (Min =1, Max=4) and 34/48 indicators (71%) had scores less than 2 on a 1 to 5 scale. The weakest technical areas in the “Prevent” category were antimicrobial resistance, biosafety and biosecurity, and National legislation, policy and financing. In the “Detect” category, the median score was 2. Technical areas with the lowest median scores were Reporting and National Laboratory System. Emergency Response Operations, Preparedness, Medical Countermeasures and Personnel Deployment had the lowest scores in the “Respond” category. Chemical Events and Points of Entry had the lowest score in “Other IHR-related hazards and Point of Entry” category. Recommendations from the JEE to address the gaps will be aligned in a costed National Action Plan for Health Security (NAPHS) and implemented using national resources, external donors and multilateral agencies. Key words: International Health Regulation, Joint External Evaluation, Health security, Cameroon.


2020 ◽  
Vol 18 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Olubunmi Eyitayo Ojo ◽  
Mahmoud Dalhat ◽  
Richard Garfield ◽  
Chris Lee ◽  
Oyeronke Oyebanji ◽  
...  

2019 ◽  
Vol 4 (6) ◽  
pp. e001312 ◽  
Author(s):  
Ambrose Talisuna ◽  
Ali Ahmed Yahaya ◽  
Soatiana Cathycia Rajatonirina ◽  
Mary Stephen ◽  
Antonio Oke ◽  
...  

The International Health Regulations (IHR, 2005) are an essential vehicle for addressing global health security. Here, we report the IHR capacities in the WHO African from independent joint external evaluation (JEE). The JEE is a voluntary component of the IHR monitoring and evaluation framework. It evaluates IHR capacities in 19 technical areas in four broad themes: ‘Prevent’ (7 technical areas, 15 indicators); ‘Detect’ (4 technical areas, 13 indicators); ‘Respond’ (5 technical areas, 14 indicators), points of entry (PoE) and other IHR hazards (chemical and radiation) (3 technical areas, 6 indicators). The IHR capacity scores are graded from level 1 (no capacity) to level 5 (sustainable capacity). From February 2016 to March 2019, 40 of 47 WHO African region countries (81% coverage) evaluated their IHR capacities using the JEE tool. No country had the required IHR capacities. Under the theme ‘Prevent’, no country scored level 5 for 12 of 15 indicators. Over 80% of them scored level 1 or 2 for most indicators. For ‘Detect’, none scored level 5 for 12 of 13 indicators. However, many scored level 3 or 4 for several indicators. For ‘Respond’, none scored level 5 for 13 of 14 indicators, and less than 10% had a national multihazard public health emergency preparedness and response plan. For PoE and other IHR hazards, most countries scored level 1 or 2 and none scored level 5. Countries in the WHO African region are commended for embracing the JEE to assess their IHR capacities. However, major gaps have been identified. Urgent collective action is needed now to protect the WHO African region from health security threats.


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