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Identification and Assessment of Public Health Surveillance Gaps under the IHR (2005)

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Affan Shaikh

on 6 December 2012

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Transcript of Identification and Assessment of Public Health Surveillance Gaps under the IHR (2005)

Acknowledgments Scott JN McNabb
Public Health Practice, LLC

Heather Meeks
Defense Threat Reduction Agency

Lisa Ferland
Public Health Practice, LLC

Betiel Hadgu Haile
Public Health Practice, LLC

Meeyoung Park
Public Health Practice, LLC

Affan Shaikh
Public Health Practice, LLC

Ngozi Erondu
Public Health Practice, LLC Stella Chungong
World Health Organization (WHO) International Health Regulations (IHR) Coordination Office

Jun Xing
WHO, IHR Coordination Office

Rajesh Sreedharan
WHO, IHR Coordination Office

Stéphane de la Rocque
WHO, IHR Coordination Office
World Organization for Animal Health

Chiara Gerardi
WHO, IHR Coordination Office Objectives Address need for States Parties to measure gaps and impediments to achieve requirements for IHR surveillance capacity What are the International Health Regulations (IHR [2005])? Legally binding document with 194 States Parties that ... establishes a set of rules to support the global outbreak alert and response system improves international surveillance and reporting mechanisms for public health events strengthens national surveillance and response capacities Timeline for IHR Implementation Planning and Assessment Implementation First Extension 15 June 2007 15 June 2009 15 June 2012 15 June 2014 Second Extension 15 June 2016 Today Deadline Exceptional Circumstances Eight Core Capacities 1. National legislation, policy, and financing 2. Coordination and National Focal Point (NFP) communication 3. Surveillance 4. Response 5. Preparedness 8. Laboratory services 7. Human resources 6. Risk communication Sensitive and flexible system Event-based Introduction IHR Monitoring Monitoring questionnaire completed yearly by NFP Report aggregated data to the World Health Assembly Two of the 20 are surveillance related 2011 Surveillance Core Capacity Conception 65th World Health Assembly Resolution
May 26th, 2012 The Essential Questions How can States Parties identify surveillance gaps? What are the gaps and impediments? How does one measure the impact of the interventions? Develop best-practices framework to achieve effective and efficient public health surveillance Build the framework to identify the workflow that assesses gaps and impediments Design toolset that assesses interventions and return on investment Sources What is the current landscape of surveillance? Types Characteristics Guidelines Evaluations Sources of Data Identified public health surveillance... Domains
Components
Indicators Systematic Literature Review Public Health Surveillance Domains Disaggregated Definitions
Examples
Timeliness
Disease type
Data type
Data sources Inputs Reaggregated Methods
Reporting structure
Trigger of initial action
Analysis
Response Criteria for Selecting Indicators Will the organization be interested in this measure? Is it easily understood? Is the information easily available and can it be collected? Is it reliable? Is it cost effective to collect? Research Designing Toolset to Assess Public Health Surveillance Design & Pilot Identification and Assessment of Public Health Surveillance Gaps under the IHR (2005) Research Professor
Emory University
Rollins School of Public Health TO ENABLE AND EMPOWER EXCELLENCE IN PUBLIC HEALTH PRACTICE™ Scott JN McNabb, Ph.D., M.S. scottjnmcnabb@emory.edu
http://www.publichealthpractice.com Implementation Step 1: Develop logic models Step 2: Build indicator database Step 3: Link indicators to logic models Step 4: Create dashboard views Step 5: Pilot toolset Step 6: Conduct Principal Component Analysis (PCA) Step 7: Evaluate and improve toolset Data sources (e.g., pharmacies, emergency departments, poison control centers) Create case definition combinations of syndromes under surveillance Custom localized search query for syndromic diseases % of correctly identified illness clusters validated and support surveillance data Trigger response sequence for all detected outbreaks and events of public health importance System allows for early triggers of illness clusters leading to earlier detection of outbreaks Indicators linked to component in logic model (i.e., activities, outputs, outcomes) Sources: CDC, USAID, World Bank, and WHO Indicators developed for logic model if unavailable from authoritative sources Indicators developed for logic model if unavailable from authoritative sources Established Indicators Useful Valid Representative Accurate Reasonable Created
Indicators Specific Measurable Dashboards ISDS preliminary feedback Pilot test e-version of toolset Self-administered by in-country IHR NFP Technical support provided during assessment Data collected will generate dashboard reports Aid in weighting and selecting indicators Uses principal components as predictor variables to tease out important relationships Implementation of regulatory standard Increased quality of surveillance information Next Steps Develop software program Coordinate with WHO Collaborate with AFENET Database of key public health surveillance indicators Assess implementation Revise framework and indicators as needed Adapt for country needs Anticipated Benefits to Stakeholders Gaps and cost analysis builds on NFP annual assessment Provides business intelligence for strategic planning and data for the return on investment Describe methods to conceive and develop a model and gap assessment tool set Activities Outputs Short-term outcomes Intermediate outcomes Long-term outcomes Early warning function Indicator-based Conception Conception Conception Conception Research Academic Grey literature Logic Model for IHR Surveillance Core Capacity Logic Model for Indicator-based Surveillance Domain Logic Model for Event-based Surveillance Domain Logic Model for Syndromic Surveillance Domain Logic Model for Predictive Surveillance Domain Attainable Relevant Time-bound Activity Are there case definitions? What % of illness clusters were correctly identified? Create case definition- combinations of syndromes under surveillance Were identified illness clusters validated by clinical and support surveillance data? Indicators Yes No Yes No % Quality assurance Feedback from States Parties and WHO Identify strengths and weaknesses Validity and reliability Continuously improve user-interface Continuously update and refine indicators 20 indicators reported *Attribute score = % attributes achieved under levels 1 and 2 Remaining surveillance capacity gaps, 2012 Implementation Rapid detection of public health risks Prompt risk assessment, notification, and response risks
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