Mind the gap: an analysis of core capacities of the international health regulations (2005) to respond to outbreaks in Yemen

Abstract

Background Yemen that has been devastated by war is facing various challenges to respond to the recent potential outbreaks and other public health emergencies due to lack of proper strategies and regulations, which are essential to public health security. The aim of this study is to assess the implementation of the International Health Regulations (IHR 2005) core capacities under the current ongoing conflict in Yemen. Methods The study simulated the World Health Organization (WHO) Joint External Evaluation (JEE) tool to assess the IHR core capacities in Yemen. Qualitative research methods were used, including desk reviews, in-depth interviews with key informants and analysis of the pooled data. Result Based on the assessment of the three main functions of the IHR framework (prevention, detection, and response), Yemen showed a demonstrated or developed capacity to detect outbreaks, but nevertheless limited or no capacity to prevent and respond to outbreaks. Conclusion This study shows that there has been poor implementation of IHR in Yemen. Therefore, urgent interventions are needed to strengthen the implementation of the IHR core capacities in Yemen. The study recommends 1) raising awareness among national and international health staff on the importance of IHR; 2) improving alignment of INGO programs with government health programs and aligning both towards better implementation of the IHR; 3) improving programmatic coordination, planning and implementation among health stakeholders; 4) increasing funding of the global health security agenda at country level; 5) using innovative approaches to analyze and address gaps in the disrupted health system, and; 6) addressing the root cause of the collapse of the health services and overall health system in Yemen by ending the protracted conflict situation.

Field Epidemiology Training Program Response to COVID-19 During a Conflict: Experience From Yemen

“…The current state of conflict and the fragile healthcare system hindered the implementation of the necessary International Health Regulations (IHR) measures and limited the capacity to adopt and implement effective preparedness and response measures to the COVID-19 epidemic. This made it difficult to trace cases and hard to implement control measures (15)(16)(17)(18).…”

“…3). Thus far, four articles have been published (18,40,41,46) while more are under peer review or in preparation.…”

“…Furthermore, the Yemen FETP participated in COVID-19 research ( Table 3 ). Thus far, four articles have been published ( 18 , 40 , 41 , 46 ) while more are under peer review or in preparation.…”

Continuing Contributions of Field Epidemiology Training Programs to Global COVID-19 Response

“…WHO’s Joint External Evaluation (JEE) tool, developed to assess countries’ implementation of the IHR (2005), recognizes the importance of FETPs with a specific indicator (D.4.2 in JEE Tool version 1 and D.4.4 in version 2): FETP or other applied epidemiology training programs in place ( 7 ). Recent publications describe the discrepancy between JEE scores and outbreak response performance ( 14 , 15 ). One of Yemen’s highest JEE technical area score of 4 was in the workforce development indicator, stating that the country has “two levels of FETP or comparable applied epidemiology training programs in place in the country or in another country through an existing agreement.” However, the JEE assessment of IHR (2005) framework functions showed capacity to detect outbreaks but limited or no capacity to prevent or respond to them, reflecting that an FETP alone cannot yield an effective outbreak response.…”

Health system strengthening in fragile and conflict-affected states: a call to action

“…However, important gaps in knowledge remain in the mental health services literature, including redesigning policies and frameworks, implementing health and mental health services, and the delivery of holistic, sensitive, and good quality care that adequately meets individual needs. At the broader health system level, Noman et al [11] provided evidence of challenging outcomes when international workforce regulations are not fully implemented in FCAS. Nevertheless, over the years, there have been advances in guidelines, frameworks, and structures to improve the delivery of health services in emergencies or humanitarian crises.…”