Abstract
BackgroundThe pandemic situation due to COVID-19 highlighted the importance of global health security preparedness and response. Since the revision of the International Health Regulations (IHR) in 2005, Joint External Evaluation (JEE) and States Parties Self-Assessment Annual Reporting (SPAR) have been adopted to track the IHR implementation stage in each country. While national IHR core capacities support the concept of Universal Health Coverage (UHC), there have been limited studies verifying the relationship between the two concepts. This study aimed to investigate empirically the association between IHR core capacity scores and the UHC service coverage index.MethodJEE score, SPAR score and UHC service coverage index data from 96 countries were collected and analyzed using an ecological study design. The independent variable was IHR core capacity scores, measured by JEE 2016-2019 and SPAR 2019 from the World Health Organization (WHO) and the dependent variable, UHC service coverage index, was extracted from the 2019 UHC monitoring report. For examining the association between IHR core capacities and the UHC service coverage index, Spearman’s correlation analysis was used. The correlation between IHR core capacities and UHC index was demonstrated using a scatter plot between JEE score and UHC service coverage index, and the SPAR score and UHC service coverage index were also presented.ResultWhile the correlation value between JEE and SPAR was 0.92 (p < 0.001), the countries’ external evaluation scores were lower than their self-evaluation scores. Some areas such as available human resources and points of entry were mismatched between JEE and SPAR. JEE was associated with the UHC score (r = 0.85, p < 0.001) and SPAR was also associated with the UHC service coverage index (r = 0.81, p < 0.001). The JEE and SPAR scores showed a significant positive correlation with the UHC service coverage index after adjusting for several confounding variables.ConclusionThe study result supports the premise that strengthening national health security capacities would in turn contribute to the achievement of UHC. With the help of the empirical result, it would further guide each country for better implementation of IHR.
Highlights
Recent threats to global health security, including influenza A H1N1 (2009), Ebola virus disease (2014), MERS-Cov (2015), Zika virus disease (2016), andLee et al Globalization and Health (2022) 18:13COVID-19 (2019), have emphasized the importance of strengthening global health security capacities more than ever
While the response and radiation areas converged in the spider diagram, overall, the Joint External Evaluation (JEE) score was more conservative than the Self-Assessment Annual Reporting (SPAR) score (Fig. 2)
This study showed a significant association between JEE and SPAR; at the same time, lower JEE scores compared to SPAR scores were identified
Summary
Recent threats to global health security, including influenza A H1N1 (2009), Ebola virus disease (2014), MERS-Cov (2015), Zika virus disease (2016), andLee et al Globalization and Health (2022) 18:13COVID-19 (2019), have emphasized the importance of strengthening global health security capacities more than ever. As 196 countries, including 194 WHO member states, agreed to report the implementation of the IHR to the World Health Assembly (Resolution WHA 58.3) [2], the IHR Monitoring and Evaluation Framework was adopted to report their progress in implementing IHR. The SPAR tool consists of 13 capacities and is an annual self-assessment tool, while the JEE tool evaluates 19 technical areas and is recommended to be done every 4-5 years. Since the revision of the International Health Regulations (IHR) in 2005, Joint External Evaluation (JEE) and States Parties Self-Assessment Annual Reporting (SPAR) have been adopted to track the IHR implementation stage in each country. This study aimed to investigate empirically the association between IHR core capacity scores and the UHC service coverage index
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