scholarly journals The Joint External Evaluation process in Cameroon: Assessing the country’s capacity for health security

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.

2019 ◽  
Author(s):  
Viviane FOSSOUO NDOUNGUE ◽  
Mohamed Moctar Mouiche Molium ◽  
Christie Tiwoda ◽  
Oumarou Gnigninanjouena ◽  
Serge Alain Sadeuh-Mba ◽  
...  

Abstract Objectives The objective of this study was to present the JEE process in Cameroon as well as Cameroon’s capacities to manage public health threats in accordance with the IHR 2005. Cameroon JEE process and data for the 48 indicators within the 19 technical areas was examined.Results Cameroon's overall score was 1.98 ± 0.93 and 48/34 indicators (70.38%) had scores less than 2 on a 1 to 5 scale. In the “Detect” category the average score was 2.7. Technical areas with the lowest average scores were Reporting and National laboratory system. The weakest indicators in the “Prevent” category were antimicrobial resistance, biosafety and biosecurity, and National legislation, policy and financing. Emergency Response Operations, Preparedness, Medical Countermeasures and Personnel Deployment have the lowest scores in the “Respond” category. Chemical Events and Points of Entry have the lowest score in “Other IHR-related hazards and Point of Entry”. Scores attributed during the country self-assessment were 73% similar to those of the JEE process.


2017 ◽  
Vol 5 (9) ◽  
pp. e857-e858 ◽  
Author(s):  
Nirmal Kandel ◽  
Rajesh Sreedharan ◽  
Stella Chungong ◽  
Karen Sliter ◽  
Simo Nikkari ◽  
...  

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.


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.


2018 ◽  
Vol 3 (2) ◽  
pp. e000600 ◽  
Author(s):  
Janneth M Mghamba ◽  
Ambrose O Talisuna ◽  
Ludy Suryantoro ◽  
Grace Elizabeth Saguti ◽  
Martin Muita ◽  
...  

The Ebola outbreak in West Africa precipitated a renewed momentum to ensure global health security through the expedited and full implementation of the International Health Regulations (IHR) (2005) in all WHO member states. The updated IHR (2005) Monitoring and Evaluation Framework was shared with Member States in 2015 with one mandatory component, that is, States Parties annual reporting to the World Health Assembly (WHA) on compliance and three voluntary components: Joint External Evaluation (JEE), After Action Reviews and Simulation Exercises. In February 2016, Tanzania, was the first country globally to volunteer to do a JEE and the first to use the recommendations for priority actions from the JEE to develop a National Action Plan for Health Security (NAPHS) by February 2017. The JEE demonstrated that within the majority of the 47 indicators within the 19 technical areas, Tanzania had either ‘limited capacity’ or ‘developed capacity’. None had ‘sustainable capacity’. With JEE recommendations for priority actions, recommendations from other relevant assessments and complementary objectives, Tanzania developed the NAPHS through a nationwide consultative and participatory process. The 5-year cost estimate came out to approximately US$86.6 million (22 million for prevent, 50 million for detect, 4.8 million for respond and 9.2 million for other IHR hazards and points of entry). However, with the inclusion of vaccines for zoonotic diseases in animals increases the cost sevenfold. The importance of strong country ownership and committed leadership were identified as instrumental for the development of operationally focused NAPHS that are aligned with broader national plans across multiple sectors. Key lessons learnt by Tanzania can help guide and encourage other countries to translate their JEE priority actions into a realistic costed NAPHS for funding and implementation for IHR (2005).


2021 ◽  
Vol 9 ◽  
Author(s):  
Arnaud Orelle ◽  
Abdoulaye Nikiema ◽  
Arsen Zakaryan ◽  
Adilya A. Albetkova ◽  
Mark A. Rayfield ◽  
...  

The pervasive nature of infections causing major outbreaks have elevated biosafety and biosecurity as a fundamental component for resilient national laboratory systems. In response to international health security demands, the Global Health Security Agenda emphasizes biosafety as one of the prerequisites to respond effectively to infectious disease threats. However, biosafety management systems (BMS) in low-medium income countries (LMIC) remain weak due to fragmented implementation strategies. In addition, inefficiencies in implementation have been due to limited resources, inadequate technical expertise, high equipment costs, and insufficient political will. Here we propose an approach to developing a strong, self-sustaining BMS based on extensive experience in LMICs. A conceptual framework incorporating 15 key components to guide implementers, national laboratory leaders, global health security experts in building a BMS is presented. This conceptual framework provides a holistic and logical approach to the development of a BMS with all critical elements. It includes a flexible planning matrix with timelines easily adaptable to different country contexts as examples, as well as resources that are critical for developing sustainable technical expertise.


Author(s):  
Tilahun M. Hiwotu ◽  
Gonfa Ayana ◽  
Achamyeleh Mulugeta ◽  
Getachew B. Kassa ◽  
Yenew Kebede ◽  
...  

Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme was initiated in 45 Ethiopian laboratories.Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges.Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels.Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01); and 42% and 53% for cohort II (p < 0.01),respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified.Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.


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.


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