Challenges to the implementation of International Health Regulations (2005) on Preventing Infectious Diseases: experience from Julius Nyerere International Airport, Tanzania

Edith Bakari,Gasto Frumence

doi:10.3402/gha.v6i0.20942

Abstract

BackgroundThe International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam.DesignA cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings.ResultsSeveral challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events.ConclusionsJNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy.

Highlights

The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States
Identified themes include: low understanding of IHR (2005); poor dissemination of the national legislations and guidelines for implementation of IHR (2005); lack of clear information among officials on the designated Port of Entry (POE) for implementation of IHR (2005) in Tanzania; lack of clear coordination of plans for the implementation of IHR (2005) at Julius Nyerere International Airport (JNIA); limited access to information on IHR (2005) among implementers; lack of budget allocation for emergency preparedness plans at JNIA; lack of training and orientation to health workers at JNIA; weak laboratory network to respond to the implementation of IHR (2005) at JNIA; and a shortage of financial and material resources at JNIA
Some of the respondents, those working with Ministry of Health and Social Welfare (MoHSW) and JNIA, had little information or understanding and were unsure about the objectives of IHR (2005) as expressed by one of the respondents from MoHSW: ‘The regulations are for the implementation of health issues at POE and may be that it has been established to control the spread of diseases from outside but I am not sure . . .’ (Key Informant 3)

Summary

Introduction

The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. Conclusions: JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should ensure that implementation of the IHR (2005) follow the policy implementation framework, the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy

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Results

Discussion

Conclusion