Assessments & JEE

The purpose of the assessment process is to measure countries' individual status and progress in building the necessary capacities to prevent, detect, and respond to infectious disease threats, in accordance with the agreed GHSA targets and in support of full implementation of the international health regulations (2005). The assessments are based on a peer-to-peer model in which external experts are invited to work with the country to evaluate capacity, ensuring an objective approach and facilitating cross-sectoral learning. The assessment is a critical part of the capacity building cycle designed to inform national priority setting, target resources, and track progress.

Portrait of a doctor who worked on Ebola patients

EXTERNAL EVALUATIONS TO ASSESS NATIONAL HEALTH SECURITY CAPACITY

The Joint External Evaluation (JEE) is a voluntary, collaborative process to assess a country’s capacity under the International Health Regulations (2005) (IHR) to prevent, detect, and rapidly respond to public health threats whether occurring naturally or due to deliberate or accidental events.

For countries interested in assessing Global Health Security Agenda (GHSA)-related capacities, the JEE tool, with its more comprehensive scope, includes all elements of GHSA and has now replaced the earlier GHSA assessment tool used by some of the first countries that engaged in this assessment process. (Examples of country assessments using both these assessment tools are provided below).

The JEE allows countries to identify the most urgent needs within their health security system; to prioritize opportunities for enhanced preparedness, response and action; and to engage with current and prospective donors and partners to target resources effectively.

To learn more, visit the JEE Alliance website.

Joint External Evaluation Tool

The Joint External Evaluation Tool (JEE Tool) International Health Regulations (2005) is a data gathering instrument designed to evaluate a country’s capacities for health security, including all IHR and GHSA-relevant capacities across all relevant sectors at a national level. The tool has 19 technical areas arranged according to the following core elements:

  • PREVENTING and reducing the likelihood of outbreaks and other public health hazards and events defined by IHR is essential.
  • DETECTING threats early can save lives.
  • RESPONDING rapidly and effectively, using multi-sectoral, national, and international coordination and communication.

This tool specifically helps to:

  • Determine the baseline capacity, including gaps and needs;
  • Inform the development of implementations plans or roadmaps;
  • Measure progress on work implemented across the IHR Core Capacities; and
  • Highlight gaps and needs for current and prospective donors and partners, as well as to inform country-level planning and priority setting.

Joint External Evaluation Process

The evaluation is completed in two stages: (1) an initial self-evaluation conducted by the country using the JEE tool and (2) an in-country evaluation conducted by an external evaluation team of subject matter experts, done in close collaboration with the country.

Self-Evaluation Phase

Following an initial request to complete an evaluation, the country works to complete a self-evaluation report in collaboration with relevant in-country representatives and stakeholders, using the JEE tool. This provides an internal reflection of the country’s IHR capacities and capabilities across all 19 technical areas, which also include all GHSA-related capacities. Recognizing that achieving these capacities is a multi-sectoral activity, stakeholders may include, but are not limited to including, ministries of health, agriculture, wildlife/environment, and defense. Fundamental to this multi-sectoral approach is the acknowledgement that infectious disease threats to humans can emerge from other humans, from commercial livestock, and from wildlife, and surveillance, testing, and response capabilities need to exist to respond to threats that could arise from any of these sectors. Similarly, response functions for outbreaks, regardless of origin or source, can exist within multiple sectors, including disaster response, security, and defense. Stakeholders in these sectors are asked to provide all information necessary (including supporting documentation, if applicable) to facilitate a thorough understanding of the country’s capabilities for each technical area.

External Evaluation Phase

Once the self-evaluation is complete, the host country shares it with the Joint External Evaluation Team. The Joint External Evaluation Team is a multi-sectoral team comprising experts from member states, World Health Organization, World Organization for Animal Health, Food and Agriculture Organization, INTERPOL, and other key international organizations. Over the course of approximately 5 days, host country experts present their country’s capacity in the 19 technical areas covered in the JEE tool. For the same reasons as noted in the self-evaluation above, all relevant sectors participate in the presentations and discussions, including human and animal health, wildlife, security, interior, defense, and others as appropriate.

The Joint External Evaluation Team works in a fully collaborative manner with host country officials to assign scores for each indicator, as well as identifying strengths and best practices, areas that need strengthening, challenges, and three to five key priority actions for each technical area. Field trips enhance the Joint External Evaluation Team’s knowledge and understanding of the host country’s capacities. Joint External Evaluations are peer-to-peer reviews, which utilize and build on previous assessments, such as IHR self-assessments and World Organziation for Animal Health's (OIE’s) Performance of Veterinary Services assessments (PVS), to help the host country prioritize key actions that will most effectively increase the ability to prevent, detect, and rapidly respond to health emergencies, whether naturally occurring, deliberate, or accidental, toward full compliance with country IHR and OIE obligations.

Preliminary results are presented to the country's high-level representatives from across relevant sectors on the final day of the mission, and a final report is typically completed within 2 weeks. The final report is shared with the country for feedback, after which it is posted online.

Post Evaluation – Matching Gaps with Resources

Following the conclusion of the Joint External Evaluation mission, countries are able to utilize the data and lessons learned from the evaluation process in order to inform country-level planning and priority setting. As the final reports contain approximately 60 jointly developed priority actions, the country is able to use these to develop a comprehensive national plan of action. This plan of action should include milestones for each year, identify areas that require concerted effort, including where external support by partners is provided and/or required (technical, financial, etc.), as well as areas for host government prioritization for technical and/or financial resources. In using the JEE to develop its plan of action, the country is able to highlight gaps and needs for both current and prospective donors and partners in an effort to fill gaps with resources. Follow-up Joint External Evaluations are recommended on a periodic basis to track progress toward achievement of the Joint External Evaluation targets and full IHR and PVS compliance.

Evaluations

Joint External Evaluation Mission Reports

 

Access Joint External Evaluation reports published by WHO.

Examples of earlier GHSA External Assessments (process and tool now replaced by JEE):