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** RAND WORKING DOCUMENT FOR MBDS ** 1

Mekong Basin Disease Surveillance (MBDS) Cooperation

MBDS Monitoring within the Context of the

International Health Regulations

Human Resource Development (HRD) Indicators

Draft for discussion by MBDS HRD working group

January 24, 2011


The World Health Organization (WHO) has developed assessment guidelines that

countries should use for monitoring the development of core capacities required by the

International Health Regulations (IHR). (WHO 2010) The WHO framework

encompasses three broad areas to be monitored across the full scope of the IHR:

Core capacities (n = 8): national legislation, policy and financing;

coordination and National Focal Point communications; surveillance;

response; preparedness; risk communication; human resources; laboratory

Human health hazards (n = 4): zoonotic events; food safety; chemical events;

radiological and nuclear events

Points of Entry – PoE (n = 1)

WHO convened a group of technical experts to develop specific indicators that countries

should use to monitor their capabilities in these areas. The 2010 WHO guidelines define

four distinct capability levels:

Capability level <1: Foundational or prerequisite level, representing the

critical attributes that would facilitate implementation of the IHR. Any

attribute not in place at this basic level should be addressed as a priority.

Capability level 1: Moderate level capability, reflecting that inputs and

processes needed to achieve IHR core capacities are largely in place.

Capability level 2: Strong technical capacity and high level of performance

through defined public health outputs and outcomes, typically at both national

and sub-national. This level corresponds to IHR requirements specified for

2012, i.e., the level of attainment for all core capacities expected of all

countries by 2012.

Capability level 3: Advanced technical capacity, contributions to IHR core

capacities beyond a States Party‟s own borders and a “reference model” for

other countries in terms of generating information, products and tools

reflecting standards or best practices that other countries can use.

Since 2001, countries in the Mekong Basin have been collaborating through the Mekong

Basin Disease Surveillance (MBDS) cooperation. MBDS collaboration focuses primarily

at distal levels of each country‟s health system, specifically cooperation in disease

surveillance and response at designated cross-border sites, and the provincial and national

support needed to enable this local cooperation. Not surprisingly, capacity building

within MBDS programming is consistent with the core capacities required by the IHR.

Indeed, the IHR requires that countries develop key capacities at all relevant levels, and

the 2010 WHO monitoring guidelines call for assessment at “national, intermediate and

local community/primary response levels.” As such, MBDS represents “bottom-up

[MBDS] meeting top-down [IHR].”


In 2010, the MBDS Executive Board endorsed a new MBDS Master Plan for 2011-2016.

The plan is organized around the seven inter-related strategies shown in the figure below.

The new MBDS plan includes activities, indicators and outputs related to each of the

seven strategies.

The 2010 WHO IHR

monitoring guidelines

describe 30 indicators, 20

of which countries are expected to report annually to the World Health Assembly and ten

that are optional. MBDS stakeholders wish to reconcile MBDS monitoring with

monitoring related specifically to IHR and to other relevant programs, such as the Asia-

Pacific Strategy for Emerging Diseases (APSED), the U.S. CDC Field Epidemiology

Training Program (FETP) assessment matrix, and the WHO matrix for assessing FETP

capacity (see list of references). Because MBDS programming focuses on local activities

(and accompanying provincial and national support) that are consistent with IHR core

capacities, it is more efficient to link MBDS monitoring to the extent possible with

monitoring of IHR and other relevant programs, with supplemental MBDS indicators as

needed; such an approach is preferable to creation of a totally separate set of indicators

for MBDS. The latter approach could cause confusion at all levels.

The first table below maps MBDS strategies and activity-specific indicators onto the IHR

indicators. Only IHR indicators relevant to MBDS are included -- indicators related to the

two IHR core capacities and two potential human health hazards neither addressed by nor

relevant to MBDS are excluded. Required IHR indicators are shown in bold font;

optional indicators are in normal font. The second table below maps the two sets of

indicators in the opposite direction, indicating for all specific MBDS activities the

corresponding 2010 IHR indicators. Nearly all planned MBDS activities (and, by

extension, their associated indicators) map onto the IHR monitoring framework. Of the

54 distinct MBDS activities, only 12 have no clear-cut correlate on the IHR indicator list,

including all indicators for the policy research strategy. Nonetheless, examination of

those activities (1.1, 1.2, 1.5, 4.1, 4.2, 4.3, 7.1-7.6) will indicate that they, too, are


consistent with IHR priorities. This further justifies tying MBDS monitoring to

monitoring of IHR indicators.

IHR indicators and corresponding MBDS strategies and activities

IHR indicator MBDS strategy (and activity number)

CORE CAPACITIES

1. National legislation, policy and financing Not addressed specifically by MBDS

2. Coordination & National Focal Point

communications Not addressed specifically by MBDS

3. Surveillance

Indicator based, routine surveillance

includes an early warning function for the

early detection of public health events.

1 – Cross-border cooperation (1.3, 1.4)

4 – Information & communications

technologies – ICT (4.4)

Event based surveillance is established 2 – Community-based surveillance (2.8

– 2.12)

A coordinated mechanism is in place for

collecting and integrating information from

sectors relevant to the IHR

1 – Cross-border cooperation (1.3, 1.4)

4 – Information & communications

technologies – ICT (4.5)

4. Response

Public health emergency response

mechanisms are established.

1 – Cross-border cooperation (1.9)

3 – Epidemiology capabilities (3.7)

Case management procedures for IHR

relevant hazards are established. 1 – Cross-border cooperation (1.8)

Infection prevention and control (IPC) is

established at national and hospital levels 1 – Cross-border cooperation (1.7)

A program for disinfection, decontamination

and vector control is established

Relevant but not addressed specifically

by MBDS

5. Preparedness

A multi-hazard national public health

emergency preparedness and response plan

has been developed

Relevant but not addressed specifically

by MBDS

Public health risks and resources are

mapped.


3 – Human resources (3.9)

4 – ICT (4.6)

6. Risk communication

Mechanisms for effective risk

communication during a public health

emergency are established.

6 – Risk communication (6.1-6.6)


IHR indicator MBDS strategy (and activity number)

7. Human resources

Human resources are available to

implement IHR core capacity

requirements.

3 – Human resource development (3.1-

3.6, 3.8)

8. Laboratory

A coordinating mechanism for laboratory

services is established.

5 – Laboratory (5.1-5.5)

Laboratory services to test for priority

health threats are available and accessible.

Influenza surveillance is established

A system for the collection, packaging &

transport of specimens is established.

Laboratory biosafety and biosecurity

practices are in place.

Laboratory data management

HUMAN HEALTH HAZARDS

1. Zoonotic events

Mechanisms for detecting and responding 2 – Animal-human interface (2.1-2.6)

2. Food safety

Mechanisms are established for detecting

and responding to foodborne disease and

food contamination

Relevant but not addressed specifically by

MBDS

3. Chemical events Not addressed specifically by MBDS

4. Radiological and nuclear events Not addressed specifically by MBDS

EVENTS AT POINTS OF ENTRY

General obligations at PoE are fulfilled.


Compliance with IHR (2005) for PoE and for

health and technical documents is established.

Coordination in the prevention, detection and

response to public health events at PoE is

established.

Effective surveillance is established at PoE.

Effective response is established at PoE.


MBDS activities and corresponding IHR indicators

MBDS Activities

IHR indicators

Core capacities Health

risks PoE

3 4 5 6 7 8 1 2

MBDS Strategy 1: Cross-border (XB) cooperation

1.1 Identification of new XB sites

1.2 Basic package of activities for XB sites

1.3 Surveillance information exchange x

1.4 Regular meetings of XB sites

1.5 Regular supervisory visits to XB sites

1.6 Border health quarantine at check points x

1.7 Infection control in medical facilities x

1.8 Patient isolation capacity x

1.9 Outbreak response capacity (real/drill) x

1.10 Updated resource mapping x

MBDS Strategy 2: Human-animal sector interface and community-based surveillance

Animal-human interface

2.1 Identification of priority diseases x

2.2 Mechanisms for collaboration, info sharing x

2.3 Development of model tabletop exercise (TTX) x

2.4 Protocol for joint outbreak investigation x

2.5 Regular info sharing between sectors x

2.6 Sharing cross-sector info across countries x

2.7 Cross-sector outbreak investigation or TTX x

Community-based surveillance

2.8 Selection of priority diseases/events x

2.9 Development of guidelines x

2.10 Development/testing of model at XB site/s x

2.11 Training of volunteers, implementation x

2.12 Regular reporting from communities x

MBDS Strategy 3: Human resources and epidemiology

3.1 Surveillance evaluation and joint outbreak

investigation into RRT/FETP training x

3.2 Short-course epidemiology training x

3.3 Workshops on epi, scientific writing, lab, GIS x

3.4 Training of country training directors x

3.5 Long-term epidemiology training x


MBDS Activities

IHR indicators

Core capacities Health

risks PoE

3 4 5 6 7 8 1 2

3.6 Scientific meetings to share experiences x

3.7 Joint outbreak investigation &/or surveillance

evaluation x

3.8 Monitoring & evaluation of activities x

3.9 Resource mapping x

MBDS Strategy 4: Information & communications (ICT)

4.1 ICT policy proposal

4.2 Capacity assessment

4.3 Plan development

4.4 Routine ICT use in surveillance & reporting x

4.5 Routine ICT use across MBDS countries x

4.6 Resource mapping x

MBDS Strategy 5: Laboratory

5.1 Filling gaps based on capacity assessment x

5.2 Capacity development for core diseases x

5.3 Proficiency testing for core diseases x

5.4 Regional protocol for specimen collection,

transport, reference testing x

5.5 Promotion of new diagnostic technologies x

MBDS Strategy 6: Risk communications (RC)

6.1 RC framework and plan x

6.2 RC curriculum x

6.3 RC training x

6.4 Message development and testing x

6.5 Implementation x

6.6 Emergency equipment x

MBDS Strategy 7: Policy research

7.1 Identification of research priorities

7.2 Study protocol

7.3 Funding

7.4 Implementation, analysis, report

7.5 Application of findings

7.6 Dissemination of results


The indicator tables on the pages that follow are organized based on the 2010 WHO IHR

monitoring framework. Specifically, they describe the different capability levels for

required (bold) and optional (not bold) IHR indicators, taken directly from the 2010

WHO IHR monitoring guidelines (these items are shown in gray). The tables also

include proposed supplemental MBDS human resource development (HRD) indicators to

guide more targeted action in that area (these items are shown in white). The final section

of this document includes tables to capture summary information across all the indicators.

The supplemental MBDS indicators add value for monitoring MBDS HRD activities and

outputs and also fit nicely within the overall IHR organizing framework. Ultimately, it

may be desirable to add supplemental indicators relevant to the full range of MBDS

strategies, but that is beyond the purview of this document.

The IHR monitoring framework is timely and seems appropriate as MBDS embarks on

its new plan of action for 2011-2016. It may also be of interest to other sub-regional

surveillance networks, e.g., through the global CHORDS initiative1 in which MBDS

participates.

1 Connecting Health Care Organizations for Regional Disease Surveillance (CHORDS) is an initiative

organized by the Global Health and Security Initiative of the nonprofit Nuclear Threat Initiative,

headquartered in the United States.

Core Capacities


HRD Indicators for MBDS – Linked to both IHR and MBDS Action Plan

CORE CAPACITIES

Core capacity component

Country level indicator

Status of development of IHR capacities, by capability level

<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

IHR Core Capacity 3: Surveillance (MBDS Strategy 1 – Cross-border cooperation & Strategy 2 – Community surveillance)

Routine surveillance

Indicator based, routine,

surveillance includes the

early warning function

for the early detection of

public health events.

A list of priority diseases,

conditions and case

definitions for surveillance

is available.

There is a specific unit

designated for surveillance

of public health risks.

Surveillance data on

epidemic prone and priority

diseases are analyzed at

least weekly at national and

sub-national levels.

Baseline estimates, trends

and thresholds for alert and

action are defined for the

local public health response

level for priority diseases/

events.

Timely reporting from at

least 60% of all reporting

units takes place.

Reports or other

documentation that

deviations or values

exceeding thresholds are

detected and used for

action at the primary

public health response

level are available.

Timely, reporting from

>80% of all reporting units

takes place.

At least quarterly feedback

of surveillance results is

disseminated to all levels

and other relevant

stakeholders.

Evaluation of the early

warning function of

routine surveillance and

country experiences,

findings and lessons

shared with the global

community is performed.

Are there surveillance

units/offices in place? *1

(Foundational level –IHR)

At National level

/provincial level

Not dedicated

Inadequately equipped and

funded

Personnel are not trained

At National level:

Dedicated unit in

operation

Roles and responsibilities

clearly defined

Trained personnel can be

contacted by phone, fax

and/or email on a 24/7

At the Sub-national /

provincial level:

Dedicated unit in

operation


clearly defined



All district level:

Dedicated unit in

operation


clearly defined




Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability basis including holidays

All urgent events were

verified and assessed

within 48 hours over the

past 12 months


basis including holidays




past 12 months

basis including holidays




past 12 months

Event-based surveillance

Event based surveillance

is established.

Information sources for

public health events and

risks are identified.

A local community level/

primary response level

reporting strategy has

been developed.

Unit(s) designated for

event-based surveillance

that may be part of existing

routine surveillance system.

SOPs and guidelines for

event capture, reporting,

confirmation, verification,

assessment and notification

are developed and

disseminated.

System in place at national

and/or sub-national levels

for capturing and registering

public health events from a

variety of sources including

veterinary, media (print,

broadcast, community,

electronic, internet etc.).

SOPs and guidelines for

event capture, reporting,

confirmation, verification,

assessment and notification

are implemented, reviewed

and updated as needed.

Active engagement and

sensitization of community

leaders, networks, health

volunteers, and other

community members, in

the detection and reporting

of unusual health events as

required.

Local community

reporting evaluated and

results shared with the

respective communities

and stakeholders.

Country experiences and

findings on

implementation of event-

based surveillance, and the

integration with indicator

based surveillance, is

documented and can be


community.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

The decision instrument

in Annex 2 of the IHR

(2005) is used to notify

WHO.

100% of events that meet

criteria for notification

under Annex 2 of IHR have

been notified by NFP to

WHO (Annex 1A Art 6b)

within 24 hours of

conducting risk

assessments.

The use of the decision

instrument is reviewed and

procedures for decision

making are updated on the

basis of lessons learnt.


findings in notification and

use of Annex 2 of the IHR

are documented and

shared globally.

Are there guidelines and

SOPs in place to guide the

reporting, filtering, and

verification of information

reported? 1

(Capability levels 1 and 2

– IHR)

None Draft national guidelines /

SOPs are in process of

being approved and

finalized.

National guidelines / SOPs

approved and being used

in selected pilot areas only

National guidelines/ SOPs

being used by entire

country to guide national

and local staff with event

reporting, verification and

assessment.

Guidelines are consistent

with the WHO EBS guide.

Situation awareness

A coordinated mechanism

is in place for collecting

and integrating

information from sectors

relevant to the IHR.


of various ministries in

contributing relevant

surveillance data on IHR

relevant hazards are

defined.

A communication

mechanism is established

for sharing surveillance

data with relevant

authorities across the

levels of the health system

and between sectors and

partners.

A mechanism is

established for

maintaining a

comprehensive

surveillance overview of

all relevant urgent health

risks.

An up to date nationwide

overview on surveillance

of all IHR relevant hazards

is available and published

annually.

IHR Core Capacity 4: Response (MBDS Strategy 3 – Epidemiologic capabilities)

Rapid response capacity

Public health emergency

response mechanisms are

established.

Resources for rapid

response during outbreaks

of national or international

concern are accessible.


response management

procedures are established

for command,

communications and control

A functional, dedicated

command and control

operations centre.

Emergency response

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

during emergency response

operations.

management procedures

are evaluated after a real or

simulated public health

response.

Rapid Response Teams

(RRTs) are available.

A roster of trained RRT

members is available and

SOPs for their deployment

are available.

Multidisciplinary RRTs are

deployed within 48 hrs from

the time when the decision

to respond is made.

Preliminary written reports

on investigation and control

measures are submitted by

RRTs to relevant authorities

within one week of

investigation

RRTs are mobilized for

actual events or simulation

exercises are conducted at

least once a year at the

relevant levels.

Evaluations of response,

including for timeliness

and quality, are

systematically carried out

and response procedures

are updated as necessary.

Assistance is offered to

other States Parties for

developing their response

capacities or

implementing control

measures.

Is there a central unit

responsible for

outbreak/event response in

the country? 1

No central/ national unit or

office

There are some resources at

the national level, but they

are:

o Not dedicated

o Inadequately

equipped and limited

funds

o Inadequately staffed

(personnel not

trained)

Dedicated national unit

established

Terms of reference

identified

The equipment and

funding are sufficient for

most key activities

Personnel have some

basic training in

Dedicated national unit in

full operation:

Carrying out all activities

identified in the ToRs

Equipment and funding

are sufficient for all

activities

Personnel have had

comprehensive training in

outbreak response

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

There are frequently

difficulties in mobilizing

a rapid and appropriate

response to outbreaks

(lack of technical and

logistical support to

proper investigation)

outbreak/event response

There are sometimes


rapid and appropriate

response to outbreaks

(some, but inadequate,

technical and logistical

support for proper

investigation)

There are rarely


a rapid and appropriate

response to outbreaks.

Central level provides

effective support to

conduct outbreak

investigation and rapid

response

Is there a multidisciplinary

Rapid Response Team

(RRT) at national level? 1

None There is a rapid response

team at the national level

but it is not

multidisciplinary.

There is a

multidisciplinary RRT

trained at the national

level, with at least one

team member trained in:

– Epidemiology

– Clinical medicine

There is a

multidisciplinary RRT

trained at the national

level with at least one

team member trained in:

– Epidemiology

– Clinical medicine

– Laboratory

– Infection Control

– Risk communication

>80% of outbreaks were

responded to in the

previous 12 months

Are there RRTs at sub-

national (e.g., provincial)

level? 1

There is no RRT trained at

sub national level

There are RRTs at the

sub national level but

they are not

multidisciplinary and/or

are present in <50% of

sub national jurisdictions

(e.g., provinces)

There is an RRT in at least

50% of sub national

jurisdictions (e.g.

provinces)

These RRTs have at least

two sectors (e.g., human

and animal health) and/or

two disciplines (e.g.,

epidemiology and clinical

There are

multidisciplinary RRTs

in most (at least 90%)

sub national jurisdictions,

with at least one member

in each RRT trained in:

– Epidemiology

– Clinical and/or

veterinary medicine

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability medicine) represented. – Laboratory

– Infection Control

– Risk communication

>80% of outbreaks

responded to in the

previous 12 months

Do lab staff participate in

outbreak investigations, or

is laboratory training

provided for RRTs? *1

No representatives from

any lab participate in

outbreak investigation

No training for RRTs has

been conducted

Lab representatives are

occasionally invited on an

ad hoc basis to be part of

the outbreak investigation

team

National level responders

have received lab training,

and/or national level

laboratory personnel have

received training in

outbreak investigation.

Lab representatives are

usually invited to be part

of the outbreak

investigation team

Sub-national level

responders have received

lab training, and/or sub-

national level laboratory

personnel have received

training in outbreak

investigation.

It is documented policy

of the Outbreak Response

Unit within MOH, that

each outbreak

investigation team should

include a lab

representative

Local level responders

have received lab training,

and/or local level

laboratory personnel have

received training in

outbreak investigation.

Case management

Case management

procedures are established

for IHR relevant hazards.

Case management

guidelines are available for

priority epidemic prone

diseases.

Case management

guidelines have been

developed and are available

at relevant health system

levels for priority

diseases60 and IHR relevant

hazards.

SOPs are available for the

management and transport

of potentially infectious

patients in the community

and at PoE.

Patient referral and

transportation systems are

implemented according to

national or international

guidelines.

Appropriate staff (as

defined by the country) is

trained in management of

relevant IHR related

emergencies.

Country experiences on

case management of major

biological, chemical,

radiological and nuclear

contamination events are

published and shared with

the global community.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Infection control

Infection prevention and

control (IPC) is

established at national

and hospital levels.

Responsibility is assigned

for surveillance of health-

care associated infections

and antimicrobial

resistance.

A national IPC policy, or

guidelines and operational

plan, is available.

SOPs, guidelines and

protocols for IPC are

available to all hospitals.

National coordination with

defined strategies,

objectives, priorities and

nature of data for the

surveillance of relevant

events (such as healthcare-

associated infections,

infections of potential

public health concern) is

set-up.

All tertiary hospitals have

designated area(s) and

defined procedures for the

care of patients requiring

specific isolation

precautions65 according to

national or international

guidelines.

Norms are defined or

guidelines developed for

protecting health care

workers.

Infection control plans are

implemented nationwide,

with documented review

of implementation.

Management of patients

with highly infectious

diseases meets established

IPC standards.

Surveillance in high risk

groups to promptly detect

and investigate clusters of

infectious disease patients,

as well as unexplained

illnesses in health workers

is established.

A monitoring system for

antimicrobial resistance

has been implemented and

data on magnitude and

trends are available.

Qualified IPC

professionals are at least in

place at all tertiary

hospitals.

Compliance with infection

control measures and

effectiveness is regularly

evaluated and published.

A national programme for

protecting health care

workers is implemented.

Are there trained infection

control focal points

Persons trained in the

principles of standard and In 51-75% of all hospitals In >75% but not all

hospitals

Trained IC personnel in

all hospitals

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability allocated in hospitals?

1 transmission-based

precautions, waste

management and

sterilization and disinfection

methods, and IC personnel

coordinates infection control

activities within the hospital:

In <50% of all hospitals,

or only at designated

hospitals.

Disinfection,

decontamination, vector

control

A program for

disinfection,

decontamination and

vector control is

established.

An up-to-date inventory of

essential materials for

disinfection and vector

control has been done.

Essential materials for

disinfection,

decontamination and

vector control are

available at relevant sites.

Decontamination

capabilities are established

for chemical

decontamination to

address main chemical

risks.

Decontamination

capabilities are established

for radiological and

nuclear hazards as relevant

to the country‟s situation.

Assistance is offered to

other States Parties for

developing their

disinfection and

decontamination

capacities.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

IHR Core Capacity 5: Preparedness (Applies broadly across MBDS Strategies)


preparedness & response

Multi-hazard National

Public Health Emergency

Preparedness and

Response Plan is

developed.

Assessment of core

capacities for IHR

implementation has been

conducted (Annex 1A

Article 2) and the report

shared with relevant

national stakeholders.

A national plan to meet the

IHR core capacity

requirements has been

developed (Annex 1A

Article 2).

National public health

emergency response plans

for IHR related hazards

and PoE have been

developed (Annex 1A,

Article 6g).

The national public health

emergency response plan

is tested in actual

emergency or simulation

situations and updated as

needed.


findings on emergency

response and mobilizing

surge capacity have been

documented and shared

with the global

community. A policy, strategy or

national plan for surge

capacity to respond to

public health emergencies

of national and

international concern is

available.

Surge capacity is tested

either by responding to a

public health event, or

during an exercise and

documentation is

adequate.

IHR risk and resource

management

Public health risks and

resources are mapped.

A directory of experts in

health and other sectors to

support a response to the

IHR related hazards is

available.

A national risk assessment

has been conducted to

identify the most likely

sources of „urgent public

health event‟ and

vulnerable populations.

National resources have

been assessed to address

priority risks.

Experts have been

mobilized from multiple

disciplines/sectors in

response to an actual

public health event or

during a simulation

exercise in the last 12

months.

The national risk profile

and resources are assessed

regularly over time (e.g.

yearly) to accommodate

emerging threats.

National plan for

management and

distribution of stockpiles is

in place.

Stockpile management

system tested through a real

or simulated exercise and

updated.

Stockpiles (critical stock

Contributes to international

stockpiles.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability levels) for responding to

priority biological, chemical

and radiological events and

other emergencies are

available and accessible at

all times.

IHR Core Capacity 6: Risk Communication (MBDS Strategy 6 – Risk communication)

Policy and procedures for

public communications

Mechanisms for effective

risk communication

during a public health

emergency are

established.

Risk communication

partners and stakeholders

are identified.

A unit responsible for

coordination of public

communications during a

public health event is

designated, with roles and

responsibilities of the

stakeholders clearly

defined.

A risk communication

plan including social

mobilization of

communities has been

developed.

Policies, SOPs or

guidelines are

disseminated on the

clearance and release of

information during a

public health event.

Policies or guidelines are

available to support

community-based risk

communication

interventions during public

health emergencies.

A risk communication plan

has been implemented in

>50% of public health

events of national or

potential international

concern in the last 12

months.

Evaluation of the public

health communication after

emergencies, including for

timeliness, transparency

and appropriateness of

communications, is carried

out and SOPs updated as

needed.

Results of evaluations of

risk communications

efforts during a public

health emergency have

been shared with the

global community.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Populations and partners

have been informed of a

real or potential risk within

24 hours following

confirmation in >30% of

public health emergencies

in the last 12 months.

A regularly updated

information source is

accessible to media and the

public for information

dissemination.

Accessible and relevant

information, education and

communications materials

tailored to the needs of the

population are available.

Populations and partners

have been informed of a

real or potential risk within

24 hours following

confirmation in >50% of

PH emergencies in the last

12 months.

Have personnel been

identified to lead

communication during

outbreaks/ crises? 1

(Foundational level – IHR)

No spokespersons

designated

No officials/ technical

staff trained as

spokespersons

Governmental officials/

technical staff trained and

act as spokespersons during

outbreaks only (HOW IS THIS

DIFFERENT FROM CAPABILITY LEVEL 2 ITEM?)

Key spokespersons

designated and trained at

national level only (HOW IS

THIS DIFFERENT FROM CAPABILITY LEVEL 1 ITEM?)

Designated person

accountable for leading

the response/ verifying

phases (IS THIS A

COMMUNICATIONS FUNCTION?)

Designated person

responsible for

implementing various

communications activities

Designated, trained

spokespersons at both

national, regional, local

level with authority to

verify, clear and release

information

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Is there training on risk

communication? 1

None. Developing a plan for risk

communication training to

include public health staff

Some training conducted

Risk communication

officers and spokespersons

trained

Relevant officials and

technical staff trained

Risk communication

officers and spokespersons

trained annually

Relevant officials and

technical staff trained

every year

Communications team that

can implement a national

emergency plan during an

outbreak, is trained

IHR Core Capacity 7: Human Resources (MBDS Strategy 3 – Human resource development)

Human resource capacity

Human resources are

available to implement

IHR core capacity

requirements.

A responsible unit has

been identified to assess

human resource capacity

to meet country IHR

requirements.

Critical gaps in existing

human resources

(numbers and

competencies) to meet

IHR requirements are

identified.

A training needs

assessment has been

carried out and plan to

meet IHR requirements

has been developed.

Workforce development

plans and funding for the

implementation of the IHR

approved by responsible

authorities.

Targets are achieved for

meeting workforce

numbers and skills

consistent with milestones

set in the training

development plan.

A strategy is developed for

the country to access field

epidemiology training (one

year or more) in-country,

regionally or

internationally.

A specific program and

budget is allocated to train

workforce for IHR

relevant hazards.

Training opportunities or

resources are used for

training staff from other

countries.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Strengthening of the

workforce is documented

when tested by an urgent

public health event or

simulation exercise.

Practitioners of PH

Epidemiology 3

<1 practitioner of PH

Epidemiology per 1

million population in

MOH, with relevant

roles & responsibilities

>1 practitioner of PH

epidemiology per

million population, as

previously described

>3 practitioners of PH

epidemiology per

million population

>1 practitioners per

province in >75% of

provinces

>10 practitioners of PH

epidemiology per 1

million population

<25% vacancies of

epidemiology

practitioners

Training indicators (especially field epidemiology training)

Long-term field

epidemiology training

programme in place 1

No type of field

epidemiology training has

been conducted or exists

Current situation not

meeting national needs:

Utilizes training

programme in another

country

Currently preparing for

program in country

(national planning

underway for field

epidemiology training,

including FETP)

Informal training

embedded in another

program

Short-course training only

RRT trained for avian

influenza response

Some form of

epidemiological training

program established in

country, duration of

training less than 1yr,

meets some national needs

No national coordinator

identified and trained for

coordinating all FETP

Meets national needs and

sustainable:

Established, long-term

(e.g., 2-year), ongoing,

accredited in-country

training program with

dedicated resources,

annual cohorts or

graduates.

A national coordinator

identified to coordinate

field epidemiology

training.

A mechanism in place to

ensure that most staff

trained continue to work

in the country surveillance

and response system.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

MOH support for training

program (Sustainability) 2

MOH authorities are

actively subverting

program or not visibly

supporting.

There is no line budget

item for Program.

No per diem support for

transport for outbreak

investigations.

MOH authorities visibly

supporting program

and/or active in

identifying partner

program.

There is line item for

Program in government

budget or from external

partner(s). (HOW IS THIS

DIFFERENT FROM CAPABILITY LEVEL 3 2ND BULLET ITEM?)

Program receives

sustainable financial and

administrative support

from MOH.

Per diem support and

transport are provided for

outbreak investigations. (HOW IS THIS DIFFERENT FROM CAPABILITY LEVEL 3 6TH BULLET ITEM?)

Program sits within MOH

organogram, MOH

provides leadership and

ownership.

There is a line in the

MOH budget for the

program and/or MOH

assists in identifying

partner support. (HOW IS

THIS DIFFERENT FROM CAPABILITY LEVEL 2 1ST BULLET ITEM?)

Program receives

substantial financial and

administrative support

from MOH.

Training staff are MOH

employees

Trainees are salaried by

MOH during training.

MOH provides per diem

and transport for outbreak

investigations. (HOW IS

THIS DIFFERENT FROM CAPABILITY LEVEL 2 3RD BULLET ITEM?)

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Training Program Staff

(Management) 2

There is no full-time

training director/

coordinator.

There is a director/

coordinator who is

assigned a majority of

his/her time (but not full

time) to FETP.

There is a director/

coordinator who is

assigned full-time (>90%)

to FETP.

There are important gaps

in the number and

qualifications of

administrative and

technical staff.

Full-time program

director/coordinator has

visibility and credibility in

MOH.

Administrative and

technical staffs are

sufficient in terms of

numbers & qualifications.

Structured curriculum with

regular review (Training) 2

Curriculum is created by

different groups, without

oversight.

Curriculum is not

reviewed.

Curriculum is structured to

achieve some of the

desired competencies.

Curriculum includes

outbreak case studies.

Curriculum is structured to

achieve all core

competencies and includes

clear objectives and

appropriate training

methods.

Occasional review and

revision of curriculum is

carried out.

Curriculum also includes

clear objectives and

appropriate training

methods. (e.g., exercises,

facilitator‟s guide,

references quizzes, etc)

Yearly review and revision

of curriculum is carried

out.

Field Sites (Training) 2 Limited orientation of host

field sites

Limited access by trainees

to data at field sites.

Field supervisors receive

orientation to program. (HOW IS THIS DIFFERENT FROM CAPABILITY LEVEL 2 1ST BULLET ITEM?)

Field sites provide trainees

with access to surveillance

data.

Field sites allow trainees

to accompany outbreak

investigations.

Field supervisors receive

some orientation and

training. (HOW IS THIS

DIFFERENT FROM CAPABILITY LEVEL 1 1ST BULLET ITEM?)

Review and use of

surveillance data by

trainees is expected. (HOW

IS THIS DIFFERENT FROM CAPABILITY LEVEL 3 2ND BULLET ITEM?)

Trainees are considered

Field supervisors are

trained or are program

graduates and have

sufficient time to work

with and mentor trainees

and document their

achievements.

Field sites/MOH provides

access to and allows

routine review and use of

surveillance data by

trainees. (HOW IS THIS

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability integral to outbreak

investigation teams.

DIFFERENT FROM CAPABILITY LEVEL2 2ND BULLET ITEM?)

Field sites/MOH provides

access to outbreak

investigation response

teams. (is this specifically

an element of training?)

Field sites provide support

for relevant public health

research by trainees.

Trainee (officer) is

considered to be doing the

necessary epidemiologic

work of the unit- not

academic assignments.

MOH retention

(Strengthened Workforce) 2

<30% of graduates enter

MOH

30-70% of graduates enter

MOH positions on

completion of training

>70% of graduates enter

MOH positions

>50% of graduates in

MOH positions remain

after 5 year.

>90% of graduates enter

MOH positions after

graduation.

> 80% remain with MOH

after 5 years.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

IHR Core Capacity 8: Laboratory (MBDS Strategy 5 – Laboratory)

Laboratory diagnostic and

confirmation capacity

Laboratory services are

available and accessible

to test for priority health

threats.

Policy to ensure quality of

laboratory diagnostic

capacity (e.g., licensing,

accreditation etc.).

An updated and accessible

inventory of public and

private laboratories88 and

their relevant diagnostic

capacity is available.

National reference

laboratory(ies) (NRL)

designated and list of NRL

disseminated to relevant

stakeholders.

Access to diagnostic

services for priority

diseases, for pathogens

listed in Annex 2 of the IHR

(2005), and for public

health threats including

hazardous substances.

National or international

external quality assessment

schemes are implemented

for diagnostic laboratories

in the country for major

public health discipline

Network of national and

international laboratories

established to meet

diagnostic and

confirmatory laboratory

requirements and support

outbreak investigations for

events specified in Annex 2

of IHR (2005).

Greater than 10 non-AFP

hazardous specimens per

year referred to national or

international reference

laboratories for

examination.

Laboratory test results are

received from the

diagnostic laboratory in a

timely manner to inform

decision-making and

actions.

All diagnostic laboratories

are certified or accredited

according to international

standards93, or to national

standards adapted from

international standards.

A national system is in place

for reliable and safe

detection of MDR and XDR

M. tuberculosis, with quality

assurance results available

for peer review and

dissemination.

Country has one or more

National Reference

Laboratory contributing to

diagnostic services in

another country.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Influenza surveillance is

established

Access to influenza

testing, nationally or

internationally

Procedures are in place for

rapid virological

assessment of clusters of

cases with severe acute

respiratory illness of

unknown cause, or

individual cases when

epidemiologic risk is high.

Participates in Global

Influenza Surveillance

Program, with regular

submission of viral

isolates for analysis.

National data/maps of

circulating strains of

influenza are available and


community.

Specimen collection and

transport

System for collection,

packaging and transport of

clinical specimens.

Sample collection and

transportation kits are

available.

National SOPs compatible

with international

guidelines are available for

the collection and

transport, of clinical

specimens.

Viable clinical specimens

from investigation of

urgent public health events

are delivered to

appropriate laboratory

within 48 hours of

collection for testing or

transport to international

reference laboratory.

At least one hazardous

specimen per year is

shipped internationally to

a collaborating laboratory

as part of an investigation

or exercise.

Sample collection and

transport kits are

prepositioned at appropriate

levels for immediate

mobilization during a public

health event.

Staff (including RRT

members) are trained in

specimen collection and

transport.

Staff at national level are

trained for the safe

shipment of infectious

substances according to

international standards

(ICAO/IATA97).

Documentation the

processes used when

investigating an urgent

public health event for

shipment of infectious

substances meet

IATA/ICAO standards.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Are there National SOPs

for specimen collection,

storage and transport? 1

(Capability level 1 – IHR)

No SOPs exist SOPs have been written

but have not been widely

distributed

There have been no (or

only minimal) training of

staff

SOPs have been written

Staff have been adequately

trained in their use

There has been no

evaluation or review

SOPs have been written

and are reviewed

regularly

SOPs are widely

distributed

Relevant staff are trained

in the use of SOPs

Laboratory biosafety and

biosecurity

Laboratory biosafety and

biosecurity practices are

in place.

Biosafety guidelines are

accessible to Individual

laboratories

Regulations, policies or

strategies for laboratory

biosafety have been

developed.

A responsible entity is

designated for laboratory

biosafety and biosecurity.

Biosafety guidelines,

manuals or SOPs are

disseminated to

laboratories.

Relevant staff are trained

on biosafety guidelines.

National classification of

microorganisms by risk

group is completed.

An institution or person

responsible for inspection

(includes certification of

biosafety equipment) of

laboratories for

compliance with biosafety

requirements is identified.

Biosafety procedures are

implemented and regularly

monitored.

Biorisk assessment is

conducted in laboratories

to guide and update

biosafety regulations,

procedures and practices,

including for

decontamination and

management of infectious

waste.

Diagnostic laboratories are

designated and authorized

or certified as BSL 2 or

above for relevant levels

of the health care system.

Country experience and

findings related to

biosafety have been

evaluated and reports


community.

Core Capacities





<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Laboratory based

surveillance

Laboratory data

management and reporting

is established.

Priority pathogens for

laboratory based

surveillance are identified.

Standard reporting

procedures between

laboratory services and the

surveillance department,

including timeliness

requirements by class of

pathogen, are established.

SOPs for data

management, data security

and data quality exist at all

diagnostic laboratories.

Analysis of laboratory data

with reports disseminated

to relevant stakeholders.

Country experience and

findings regarding

laboratory based

surveillance are published

and disseminated to the

global community.

Gray rows: Taken directly from WHO 2010

Reference1: APSED implementation monitoring tool with measurement notes (*Modified)

Reference2: CDC Matrix tool for FETP Assessment and Monitoring

Reference3: WHO quantitative Matrix (communication regarding FETP capacity)

Human Health Hazards


IHR POTENTIAL HUMAN HEALTH HAZARDS

Component of hazard


Status of development of IHR core capacities for hazard detection & response, by capability level

<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

IHR Potential hazard 1: Zoonotic events (MBDS Strategy 2: Animal-human interface)

Capacity to detect and

respond to zoonotic events

of national or

international concern

Mechanisms for

detecting and responding

to zoonoses and potential

zoonoses are established.

A regularly updated roster

(list) of experts that can

respond to zoonotic events

is available.

A mechanism for response

to outbreaks of zoonotic

diseases by human and

animal health sectors is

established.

Animal health (domestic

and wild life) is part of the

national emergency

response committee agenda.

An operational, inter-

sectoral public health plan

for responding to zoonotic

events is tested and

updated as needed.

Timely (as defined by

national standards)

response to more than 80%

of zoonotic events of

potential national and

international concern.

Is there a cross-sector

policy / mechanism in

place to coordinate

between animal and human

health sectors? 1


No policy and mechanism

in place for joint or

coordinated response.

Agreement/policy between

animal and human health

sectors and mechanism


level. (Mechanism has

been formalized and in

place with regular joint

risk assessment/ decision

making on joint response) (HOW IS THIS DIFFERENT FROM CAPABILITY LEVEL 2 1ST BULLET?)

Agreement/policy between

animal and human health

sectors and mechanism


level. (Mechanism has

been formalized and in

place with regular joint risk

assessment/ decision

making on joint response) (HOW IS THIS DIFFERENT FROM CAP LEVEL 1 1ST BULLET?)

Mechanism established at

sub national level for

coordinated/joint response


national level

(Mechanism has been

formalized and in place

with regular joint risk

assessment/decision

making on coordinated

response, etc)


sub national and local

levels for coordinated/joint

response



Component of hazard



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Is there training for

coordinated/ joint response

between animal and human

health sectors? 1

No joint response training

conducted.

Joint response training

carried out to relevant

stakeholders at national

level



stakeholders at national

and sub national level (HOW MANY PROVINCES?)



stakeholders at national,

sub national, and local

levels (HOW MANY

PROVINCES?)

IHR Potential hazard 2: Food safety (Not addressed directly by MBDS, but probably relevant)

Capacity to detect and

respond to food safety

events that may constitute

a public health emergency

of national or

international concern

Mechanisms are

established for detecting

and responding to

foodborne disease and

food contamination.

National or international

food safety standards are

available.

National food laws,

regulations or policy to

facilitate food safety control

are in place.

An operational national

multi-sectoral mechanism

for food safety events is in

place.

A functioning coordination

mechanism is established

between the food safety

authorities, specifically the

INFOSAN Emergency

Contact Point (if member)

and the IHR NFP.

Decisions of the food

safety multi-sectoral body

are implemented and the

outcomes documented.

The country is an active

member of the INFOSAN

network.



Component of hazard



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

A list of priority food

safety risks is available. Guidelines or manuals on

the surveillance,

assessment & management

of priority food safety

risks are available.

Epidemiological data

related to food

contamination are

systematically collected

and analyzed.

Food safety authorities

systematically report food

safety events of national or

international concern to

the surveillance unit

Food inspection services

(risk-based) are in place.

Access to laboratory

capacity to confirm

priority food safety events

of national or international

concern including

molecular techniques.

A roster of food safety

experts is available for

assessment and response

to food safety events.

Food safety events are

investigated by teams that

include food safety

experts.

Mechanisms are

established for tracing,

recall and disposal of

contaminated products.

Communication

mechanisms and materials

are in place to deliver

information, education and

advice to stakeholders

across the farm-to-fork

continuum.

An operational plan for

responding to food safety

events is tested and

updated as needed

Food safety control

management systems

(including for imported

food) are implemented

Information from

foodborne outbreaks and

food contamination has

been used to strengthen

food management systems,

safety standards and

regulations.

Published analysis of food

safety events, foodborne

illness trends and

outbreaks which integrates

data from across the food

chain.

Gray rows: Taken directly from WHO 2010 Reference1: APSED implementation monitoring tool with measurement notes (*Modified)

Points of Entry


POINTS OF ENTRY

PoE component


Status of development of IHR core capacity requirements at PoE, by capability level

<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

(These relate most to MBDS Strategy 1 – Cross-border cooperation)

General obligations at PoE

General obligations at

PoE are fulfilled.

A review meeting (or

other method as

appropriate) conducted on

designating PoE has been

held.

A „competent authority‟ is

designated for each PoE as

specified in Article 19B of

the IHR (2005); its

functions are specified in

Article 22 No.1.

Ports/airports are designated

for development of

capacities specified in

Annex 1 (i.e. as specified in

Article 20, No.1).

A list of Ports authorized to

offer certificates relating to

ship sanitation has been sent

to WHO (as specified in

Article 20, No.3).

>50% of designated

Airports have a competent

authority.

>50% of designated

Airports have been

assessed.

>50% of designated Ports

have a competent authority.

>50% of designated Ports have been assessed.

100% of designated

Airports have a competent

authority.

100% of designated

Airports have been

assessed.

100% of designated Ports

have a competent authority.

100% of designated Ports

have been assessed.


findings on the process of

meeting PoE general

obligations are

documented.

Points of Entry


PoE component



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Legislation and policy

technical guidance &

procedures

Compliance with the IHR

(2005) for PoE and for

health and technical

documents

Updated health documents

as specified in the IHR

(2005).

Documentation that relevant

legislation, regulations,

administrative requirements,

and other governmental

instruments have been

assessed for PoE is

available.

Technical and operational guidance for PoE is available and disseminated to relevant stakeholders.

Recommendations are

implemented following

assessment of relevant

legislation, regulations and

administrative

requirements for PoE.

Updated IHR (2005) health

documents are

implemented.

Procedures, and technical

guidelines and SOPs are

implemented and updated

as needed.


findings on

implementation of

legislation, regulation,

administrative

requirements, and other

governmental instruments

is documented.

Coordination

Coordination in the

prevention, detection, and

response to public health

events at PoE is

established.

A list of sectors and

agencies for coordination

at PoE is available.

Procedures for coordination and communication between the IHR NFP and the PoE competent authority, and with all relevant sectors, are established.

Procedures for

coordination and

communication between

the IHR NFP and the PoE

competent authority, and

with all relevant sectors are

tested and updated.

Procedures for

communication between

the PoE competent

authority and other

countries' PoE competent

authorities are tested and

updated as needed.

Effectiveness of

coordination between

relevant stakeholders for

PoE evaluated and

experiences are shared

with the global

community.

Surveillance at PoE

Effective surveillance is

established at PoE.

Priority conditions for

surveillance at designated

PoE are identified.

Surveillance information at designated PoE is shared with surveillance department/ unit.

Designated PoE have the

capacity to safely dispose

of potentially

contaminated products

A review of surveillance

of health threats at PoE

has been carried out in the

last 12 months and the

Points of Entry


PoE component



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Mechanisms for the exchange of information between designated PoE and medical facilities are in place.

Designated PoE have access to appropriate medical services including diagnostic facilities for the prompt assessment and care of ill travellers, with adequate staff, equipment and premises (Annex 1b, Art.1a).

Surveillance of conveyances for the presence of vectors and reservoirs at designated PoE is established (Annex 1B, Art. 2e).

Designated PoE with trained personnel for the inspection of conveyances is available (Annex 1b, Art. 1c).

A functioning programme

for the surveillance and

control of vectors and

reservoirs in and near PoE

exists (Annex 1A, Art. 6a

Annex 1b, Art. 1e).

results published.

Points of Entry


PoE component



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

Response at PoE

Effective response at PoE

is established.

SOPs for response at PoE

are available.

A public health emergency

contingency response plan

at designated PoE has

been developed and

disseminated to key

stakeholders.

Designated PoE have

appropriate space, separate

from other travellers, to

interview suspect or

affected persons (Annex

1B, Art. 2c).

Designated PoE can

provide assessment of and

quarantine of suspect

travellers and care for

affected travellers or

animals (Annex 1B, Art.

2b and 2d).

Designated PoE referral

system and transport for

the safe transfer of ill

travellers to appropriate

medical facilities and

access to equipment, in

place (Annex 1b, art 1b

and 2g).

A public health emergency

contingency plan at

designated PoE has been

integrated with other

response plans, and is

tested and updated as

needed.

Designated PoE can apply

recommended public

health measures (Art. 1B,

Art 2e and 2f).

Results of the evaluation

of the effectiveness of

response to public health

events at PoE are

published.

Have contact points for

points of entry been

nominated? 1

No unit/person identified Person/unit identified but

has minimal input and is

inadequately resourced

Person/unit identified and

has some input but is not

supported by senior

officials (WHAT IS THE

DIFFERENCE BETWEEN

Person/unit identified.

Terms of reference

defined.

Staff/unit are trained to

Points of Entry


PoE component



<1

Foundational

1

Moderate capability

2

Strong capability

3

Advanced capability

“MINIMAL” AND “SOME”?) perform their duties.

They have a significant

input into policy

development.

They are fully supported

by senior officials in the

MOH

They are adequately

resourced to carry out

their terms of reference.


Country Summary

39

Country Level Summary Tables

CORE CAPACITIES



Status of development of

IHR capacities, by

capability level

<1 1 2 3

IHR Core Capacity 3: Surveillance

(MBDS Strategy 1 – Cross-border cooperation & Strategy 2 – Community surveillance)

Routine surveillance - Indicator based, routine, surveillance includes the early warning function

for the early detection of public health events.

Are there surveillance units/offices in place? *1 (Foundational level –IHR)

Event-based surveillance - Event based surveillance is established.

Are there guidelines and SOPs in place to guide the reporting, filtering, and verification of information

reported? 1

(Capability levels 1 and 2 – IHR)

Situation awareness - A coordinated mechanism is in place for collecting and integrating information

from sectors relevant to the IHR.

IHR Core Capacity 4: Response (MBDS Strategy 3 – Epidemiologic capabilities)

Rapid response capacity - Public health emergency response mechanisms are established.

Is there a central unit responsible for outbreak/event response in the country? 1

Is there a multidisciplinary Rapid Response Team (RRT) at national level? 1

Are there RRTs at sub-national (e.g., provincial) level? 1

Do lab staff participate in outbreak investigations, or is laboratory training provided to RRTs? *1

Case management - Case management procedures are established for IHR relevant hazards.

Country Summary

40




IHR capacities, by

capability level

<1 1 2 3

Infection control - Infection prevention and control is established at national and hospital levels.

Are there trained infection control focal points allocated in hospitals? 1

Disinfection, decontamination, vector control- A program for disinfection, decontamination and vector

control is established.

IHR Core Capacity 5: Preparedness (Applies broadly across MBDS Strategies)

Public health emergency preparedness & response - Multi-hazard National Public Health

Emergency Preparedness and Response Plan is developed.

IHR risk and resource management - Public health risks and resources are mapped.

IHR Core Capacity 6: Risk Communication (MBDS Strategy 6 – Risk communication)

Policy and procedures for public communications - Mechanisms for effective risk communication

during a public health emergency are established.

Have personnel been identified to lead communication during outbreaks/crises? 1 (Foundational level –

IHR)

Is there training on risk communication? 1

IHR Core Capacity 7: Human Resources (MBDS Strategy 3 – Human resource development)

Human resource capacity - Human resources are available to implement IHR core capacity

requirements.

Practitioners of PH Epidemiology 3

Country Summary

41




IHR capacities, by

capability level

<1 1 2 3

Training indicators (especially field epidemiology training)

Field Epidemiology training programme in place 1

MOH support for training program (Sustainability) 2

Training Program Staff (Management) 2

Structured curriculum with regular review (Training) 2

Field Sites (Training) 2

MOH retention (Strengthened Workforce) 2

IHR Core Capacity 8: Laboratory (MBDS Strategy 5 – Laboratory)

Laboratory diagnostic and confirmation capacity - Laboratory services are available and accessible

to test for priority health threats.

Influenza surveillance is established

Specimen collection and transport - System for clinical specimen collection, packaging and transport.

Are there National SOPs for specimen collection, storage and transport? 1


Laboratory biosafety and biosecurity - Laboratory biosafety and biosecurity practices are in place.

Laboratory based surveillance - Laboratory data management and reporting is established.


Country Summary

42

HUMAN HEALTH HAZARDS

Component of hazard



IHR core capacities for

hazard detection &

response, by capability

level

<1 1 2 3

IHR Potential hazard 1: Zoonotic events (MBDS Strategy 2: Animal-human interface)

Capacity to detect and respond to zoonotic events of national or international concern

Mechanisms for detecting and responding to zoonoses and potential zoonoses are established.

Is there a cross-sector policy / mechanism in place to coordinate between animal and human health

sectors? 1


Is there training for coordinated/ joint response between animal and human health sectors? 1

IHR Potential hazard 2: Food safety (Not addressed directly by MBDS, but probably relevant)

Capacity to detect and respond to food safety events that may constitute a public health emergency of

national or international concern

Mechanisms are established for detecting and responding to foodborne disease and food

contamination.


Country Summary

43

POINTS OF ENTRY

PoE component



IHR core capacity

requirements at PoE, by

capability level

<1 1 2 3

(These relate most to MBDS Strategy 1 – Cross-border cooperation)

General obligations at PoE

General obligations at PoE are fulfilled.

Legislation and policy technical guidance & procedures

Compliance with the IHR (2005) for PoE and for health and technical documents

Coordination

Coordination in the prevention, detection, and response to public health events at PoE is established.

Surveillance at PoE

Effective surveillance is established at PoE.

Response at PoE

Effective response at PoE is established.

Have contact points for points of entry been nominated? 1


45

References

WHO 2010. “IHR monitoring framework: Checklist and indicators for monitoring

progress in the development of IHR core capacities in States Parties”. Geneva, 2010.

Available online at http://www.who.int/ihr/IHR_Monitoring_Framework_Checklist_and_Indicators.pdf,

as of January 3, 2011.

(PLEASE ADD FULL REFERENCE CITATIONS FOR THE 3 REFERENCES NOTED

AT THE BOTTOM OF LONG “CORE CAPACITIES” TABLE)

http://www.who.int/ihr/IHR_Monitoring_Framework_Checklist_and_Indicators.pdf

human resource development (hrd) indicators · human resource development (hrd) indicators draft...

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