Analysis of results from the Joint External Evaluation

Examining its strength and assessing for trends among participating countries

Bibliographic Data

ID19552491
AuthorsVin Gupta (Harvard Global Health Institute, corresponding author), John D Kraemer (0000-0002-8769-3393, Georgetown University), Rebecca Katz (0000-0002-2831-0866, Georgetown University), Ashish K Jha (0000-0002-6602-6444, Harvard University), Vanessa Kerry (0000-0001-9363-6830, Harvard Global Health Institute), Vanessa B Kerry, Jussi Sane (0000-0001-6590-9520, Finnish Institute for Health and Welfare), Jukka Ollgren (0000-0003-0765-4392, Finnish Institute for Health and Welfare), Mika Salminen (0000-0003-3020-0866, Finnish Institute for Health and Welfare), Mika O Salminen
Year2018
Volume8
Issue2
Pages020416-020416
Publication date2018-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.08.020416
PMID30410738
OpenAlexW2888239899
LanguageEN
Citations received19
References cited16

BACKGROUND: The Joint External Evaluation (JEE) is part of the World Health Organization's (WHO) new process to help countries assess their ability to prevent, detect and respond to public health threats such as infectious disease outbreaks, as specified by the International Health Regulations (IHR). How countries are faring on these evaluations is not well known and neither is there any previous assessment of the performance characteristics of the JEE process itself. METHODS: We obtained JEE data for 48 indicators collectively across 19 technical areas of preparedness for 55 countries. The indicators are scored on a 1 to 5 scale with 4 indicating demonstrated capacity. We created a standardized JEE index score representing cumulative performance across indicators using principal components analysis. We examined the state of performance across all indicators and then examined the relationship between this index score and select demographic and health variables to better understand potential drivers of performance. RESULTS: Among our study cohort, the median performance on 43 of the 48 (89.6%) indicators was less than 4, suggesting that countries were failing to meet demonstrated capacity on these measures. The two weakest indicators were related to antimicrobial resistance (median score = 1.0, interquartile range = 1.0-2.0) and biosecurity response (median score = 2.0, interquartile range = 2.0-3.0). JEE index scores correlated with various metrics of health outcomes (life expectancy, under-five year mortality rate, disability-adjusted life years lost to communicable diseases) and with standard measures of social and economic development that enable public health system performance in the total sample, but in stratified analyses, these relationships were much weaker in the AFRO region. CONCLUSIONS: We find large variations in JEE scores among countries and WHO regions with many nations still unprepared for the next disease outbreak with pandemic potential The strong correlations between JEE performance and metrics of both health outcomes and health systems' performance suggests that the JEE is likely accurately measuring the strength of IHR-specific, public health capabilities

Environmental health · Interquartile range · Life expectancy · Political science · Population · Preparedness · Public health · Demography · Global Security and Public Health · Medicine · Nursing · Viral Infections and Outbreaks Research · Zoonotic diseases and public health · Gerontology