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Stone AB, Weg AL, Petzing SR, Rollings A, Perdue CL. Lack of Alignment Between WHO Joint External Evaluation and State Party Self-Assessment Scores Undermines Utility as Evaluation Tools for the Department of Defense. Health Secur 2022; 20:321-330. [PMID: 35881868 DOI: 10.1089/hs.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International Health Regulations 2005 (IHR) set standards for countries to detect and respond to public health threats such as COVID-19. The US Department of Defense engages with partner nations to build IHR-related health security capacities. In this article, we compare 2 elements of the IHR Monitoring and Evaluation Framework to determine if they align in a useful way. The version of the State Party Annual Reporting tool (SPAR) used for this study is a self-assessment of 13 capacities, while the Joint External Evaluation (JEE) requires collaboration with international subject matter experts to evaluate 19 capacities. The SPAR indicators are scored separately from 0% to 100%, whereas the JEE uses a rank-ordered scale from 1 to 5 for variable numbers of indicators in each capacity. Using 2018-2019 data from the World Health Organization, we quantitatively and qualitatively evaluated the alignment of the SPAR and JEE scoring systems, using paired t tests for related capacities and 3 approaches to matching the scales. Whether using a simple, evenly divided scale for the SPAR or downscaling the SPAR scores to match with lower JEE scores, the paired t tests indicate that the JEE and SPAR scoring systems are not aligned. Many of the capacities in the JEE and SPAR are defined differently, pointing to one of the reasons for the discordance. We discuss implications for revision of the JEE and SPAR assessment tools along with ways in which the scores might be used for planning global health engagement capacity-building activities.
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Affiliation(s)
- Alexandra B Stone
- Alexandra B. Stone, PhD, MSc, is Senior Advisor for Assessment, Monitoring, and Evaluation, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Alden L Weg
- Alden L. Weg, MD, MPH, is Director, Combatant Command Support, Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Stephanie R Petzing
- Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Amber Rollings
- Amber Rollings, PhD, is an Assessment, Monitoring, and Evaluation Data Analyst, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Christopher L Perdue
- Christopher L. Perdue, MD, MPH, is a Senior Policy Analyst, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC
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de la Rocque S, Belot G, Errecaborde KMM, Sreedharan R, Skrypnyk A, Schmidt T, Isla N, Traore T, Talisuna A, Gongal G, Samhouri D, Caya F, Carron M, Kandel N, Xing J, Chungong S. Operationalisation of consensual One Health roadmaps in countries for improved IHR capacities and health security. BMJ Glob Health 2021; 6:bmjgh-2021-005275. [PMID: 34210688 PMCID: PMC8252684 DOI: 10.1136/bmjgh-2021-005275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic is a devastating reminder that mitigating the threat of emerging zoonotic outbreaks relies on our collective capacity to work across human health, animal health and environment sectors. Despite the critical need for shared approaches, collaborative benchmarks in the International Health Regulations (IHR) Monitoring and Evaluation Framework and more specifically the Joint External Evaluation (JEE) often reveal low levels of performance in collaborative technical areas (TAs), thus identifying a real need to work on the human-animal-environment interface to improve health security. The National Bridging Workshops (NBWs) proposed jointly by the World Organisation of Animal Health and World Health Organization (WHO) provide opportunity for national human health, animal health, environment and other relevant sectors in countries to explore the efficiency and gaps in their coordination for the management of zoonotic diseases. The results, gathered in a prioritised roadmap, support the operationalisation of the recommendations made during JEE for TAs where a multisectoral One Health approach is beneficial. For those collaborative TAs (12 out of 19 in the JEE), more than two-thirds of the recommendations can be implemented through one or multiple activities jointly agreed during NBW. Interestingly, when associated with the WHO Benchmark Tool for IHR, it appears that NBW activities are often associated with lower level of performance than anticipated during the JEE missions, revealing that countries often overestimate their capacities at the human-animal-environment interface. Deeper, more focused and more widely shared discussions between professionals highlight the need for concrete foundations of multisectoral coordination to meet goals for One Health and improved global health security through IHR.
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Affiliation(s)
| | | | - Kaylee Marie Myhre Errecaborde
- Health Emergencies Programme, WHO, Geneva, Switzerland,Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | | | - Artem Skrypnyk
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Tanja Schmidt
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Nicolas Isla
- Country Health Emergency Preparedness & IHR, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Tieble Traore
- Emergency Preparedness, WHO Regional Office for Africa, Brazzaville, Congo
| | - Ambrose Talisuna
- Emergency Preparedness, WHO Regional Office for Africa, Brazzaville, Congo
| | - Gyanendra Gongal
- Healthier Populations & Noncommunicable Diseases, WHO Regional Office for South-East Asia, New Delhi, India
| | - Dalia Samhouri
- Country Health Emergency Preparedness & IHR, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - François Caya
- Capacity Building Department, World Organisation for Animal Health, Paris, France
| | - Maud Carron
- Capacity Building Department, World Organisation for Animal Health, Paris, France
| | - Nirmal Kandel
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | - Jun Xing
- Health Emergencies Programme, WHO, Geneva, Switzerland
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Forshey BM, Woodward A, Sanchez JL, Petzing SR. Military Participation in Health Security: Analysis of Joint External Evaluation Reports and National Action Plans for Health Security. Health Secur 2021; 19:173-182. [PMID: 33719585 DOI: 10.1089/hs.2020.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Militaries around the world play an important but at times poorly defined and underappreciated role in global health security. They are often called upon to support civilian authorities in humanitarian crises and to provide routine healthcare for civilians. 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 endemic and emerging infectious diseases. Despite the role of militaries, few studies have systematically evaluated their involvement in global health security activities including the Global Health Security Agenda. We analyzed Joint External Evaluation (JEE) mission reports (n = 94) and National Action Plan for Health Security plans (n = 12), published as of July 2020, to determine the extent to which military organizations were involved in the evaluation process, military involvement in health security activities were described, and specific recommendations were provided for the country's military. For JEE reports, descriptions of military involvement were highest in 3 of the 4 core areas: Respond (76%), Prevent (39%), and Detect (32%). Similarly, National Action Plan for Health Security plans mentioned military involvement in the same 3 core areas: Respond (58%), Prevent (33%), and Detect (33%). Only 28% of JEE reports provided recommendations for the military in any of the core areas. Our results indicate that military roles and contributions are incorporated into some aspects of country-level health security activities, but that more extensive involvement may be warranted to improve national capabilities to prevent, detect, and respond to infectious disease threats.
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Affiliation(s)
- Brett M Forshey
- Brett M. Forshey, PhD, is a US Public Health Service Officer and an Epidemiologist and Alexandra Woodward, MPH, is a Senior Biosurveillance Specialist, Global Emerging Infections Surveillance; and Jose L. Sanchez, MD, is Deputy Chief; all with the Armed Forces Health Surveillance Division, Silver Spring, MD. Alexandra Woodward is also a Senior Biosurveillance Specialist, Cherokee Nation Strategic Programs, Tulsa, OK; and a DrPH Health Security Student, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, Henry M. Jackson Foundation, Center for Global Health Engagement, Bethesda, MD. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Department of Defense or of the US government
| | - Alexandra Woodward
- Brett M. Forshey, PhD, is a US Public Health Service Officer and an Epidemiologist and Alexandra Woodward, MPH, is a Senior Biosurveillance Specialist, Global Emerging Infections Surveillance; and Jose L. Sanchez, MD, is Deputy Chief; all with the Armed Forces Health Surveillance Division, Silver Spring, MD. Alexandra Woodward is also a Senior Biosurveillance Specialist, Cherokee Nation Strategic Programs, Tulsa, OK; and a DrPH Health Security Student, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, Henry M. Jackson Foundation, Center for Global Health Engagement, Bethesda, MD. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Department of Defense or of the US government
| | - Jose L Sanchez
- Brett M. Forshey, PhD, is a US Public Health Service Officer and an Epidemiologist and Alexandra Woodward, MPH, is a Senior Biosurveillance Specialist, Global Emerging Infections Surveillance; and Jose L. Sanchez, MD, is Deputy Chief; all with the Armed Forces Health Surveillance Division, Silver Spring, MD. Alexandra Woodward is also a Senior Biosurveillance Specialist, Cherokee Nation Strategic Programs, Tulsa, OK; and a DrPH Health Security Student, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, Henry M. Jackson Foundation, Center for Global Health Engagement, Bethesda, MD. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Department of Defense or of the US government
| | - Stephanie R Petzing
- Brett M. Forshey, PhD, is a US Public Health Service Officer and an Epidemiologist and Alexandra Woodward, MPH, is a Senior Biosurveillance Specialist, Global Emerging Infections Surveillance; and Jose L. Sanchez, MD, is Deputy Chief; all with the Armed Forces Health Surveillance Division, Silver Spring, MD. Alexandra Woodward is also a Senior Biosurveillance Specialist, Cherokee Nation Strategic Programs, Tulsa, OK; and a DrPH Health Security Student, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, Henry M. Jackson Foundation, Center for Global Health Engagement, Bethesda, MD. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Department of Defense or of the US government
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