Top

BMC Health Services Research

Published in:

Open Access 01-12-2021 | Public Health | Research article

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

Authors: Hanan Noman, Fekri Dureab, Iman Ahmed, Abdulwahed Al Serouri, Taha Hussein, Albrecht Jahn

Published in: BMC Health Services Research | Issue 1/2021

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.

Available only for authorised users

WHO. International Health Regulations. 2005. Avialable from https://www.who.int/health-topics/international-healthregulations#tab=tab_. (cited 2019, 10 July).

Katz R, Standley CJ. Regional approaches for enhancing global health security. BMC Public Health. 2019;19:473. https://doi.org/10.1186/s12889-019-6789-y.

Aldis W. Health security as a public health concept: a critical analysis. Health Policy Plan. 2008;23(6):369–75. https://doi.org/10.1093/heapol/czn030.CrossRefPubMed

Menon AN, Rosenfeld E, Brush CA. Law and the JEE: lessons for IHR implementation. Health Secur. 2018;16(S1):S-11–7.CrossRef

Ijaz K, Kasowski E, Arthur RR, Angulo FJ, Dowell SF. International health regulations—what gets measured gets done. Emerg Infect Dis. 2012;18(7):1054–7 https://doi.org/10.3201/eid1807.120487.CrossRefPubMedPubMedCentral

Philippe Calain, From the field side of the binoculars: a different view on global public health surveillance, Health Policy Plan, Volume 22, Issue 1, January 2007, Pages 13–20, https://doi.org/https://doi.org/10.1093/heapol/czl035.

WHO. Development of a draft five-year global strategic plan to improve public health preparedness and response. 2017 [cited 2019 22 July]; Available from: https://www.google.de/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=2ahUKEwiujMKUr-bjAhWLJFAKHbA3C3sQFjABegQIAhAC&url=http%3A%2F%2Fwww.wpro.who.int%2Fabout%2Fregional_committee%2F68%2Fdocuments%2Fwhe_cpi_ihr_5-year_global_strategic_plan.pdf&usg=AOvVaw0hVcocTWwNBY9zApdomlYJ.

UNDP. Assessing the Impact of War on development of Yemen. 72 (2019).[Cited Aug, 2020]; Available from: https://www.undp.org/content/dam/yemen/General/Docs/ImpactOfWarOnDevelopmentInYemen.pdf

El Bcheraoui C, et al. Health in Yemen: losing ground in war time. Glob Health. 2018;14(1):42. https://doi.org/10.1186/s12992-018-0354-9.CrossRef

10.

UNICEF. Evaluation of the UNICEF level 3 response to the cholera epidemic in Yemen: A crisis within a crisis. 2018 [cited 2019 3 July]; Available from: https://www.google.de/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=2ahUKEwidjo2ikubjAhWIzqQKHe1hB94QFjAAegQIABAC&url=https%3A%2F%2Fwww.unicef.org%2Fevaldatabase%2Ffiles%2FEvaluation_of_UNICEFs_Response_to_the_Cholera_Outbreak_in_Yemen_EOHQ_2018-001.pdf&usg=AOvVaw3RR3iyrCHCMvP4s2menh-a.

11.

Alamodi AA, Eshaq AM, Fothan AM, Bakather AM, Obad AS. Tackling preventable diseases in Yemen. Lancet. 2015;386(10010):2251–2. https://doi.org/10.1016/S0140-6736(15)01101-0.CrossRefPubMed

12.

The Lancet. Yemen's silent killers. Lancet. 2017;389(10070).

13.

Kuna A, Gajewski M. Cholera - the new strike of an old foe. Int Marit Health. 2017;68(3):163–7. https://doi.org/10.5603/IMH.2017.0029.CrossRefPubMed

14.

Kohlbacher Florian. The Use of Qualitative Content Analysis in Case Study Research [89 paragraphs]. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research. 2005;7(1):21. https://doi.org/10.17169/fqs-7.1.75, http://nbn-resolving.de/urn:nbn:de:0114-fqs0601211.

15.

Kohlbacher F. The use of qualitative content analysis in case study research. In: Forum qualitative Sozialforschung/forum: qualitative social research: Institut für Qualitative Forschung; 2006.

16.

Dureab F, Shibib K, Al Yousufi R, Jahn A. Yemen: cholera outbreak and the ongoing armed conflict. J Infect Dev Ctries 2018; 12(5):397–403. https://doi:https://doi.org/10.3855/jidc.10129

17.

WHO. Joint External Evaluation tool (JEE tool) first edition. 2016 [cited 2019 6 June]; Available from: https://www.who.int/ihr/publications/WHO_HSE_GCR_2016_2/en/.

18.

WHO. Joint External Evaluation of IHR Core Capacities of the Republic of Somalia. 2016 [cited 2019 28 July]; Available from: https://www.who.int/ihr/publications/WHO-WHE-CPI-2017.17/en/.

19.

Gaafar T, Moshni E, Lievano F. The challenge of achieving measles elimination in the Eastern Mediterranean Region by 2010. J Infect Dis. 2003;187(Supplement_1):S164–71.CrossRefPubMed

20.

Dureab F, Ismail O, Müller O, Jahn A. Cholera outbreak in Yemen: timeliness of reporting and response in the National Electronic Disease Early Warning System. Acta Inform Med. 2019;27(2):85–8. https://doi.org/10.5455/aim.2019.27.85-88.CrossRefPubMedPubMedCentral

21.

Ahmed K, Altaf MD, Dureab F. Electronic infectious disease surveillance system during humanitarian crises in Yemen. Online J Public Health Inform. 2014;6(1):e134. https://doi.org/10.5210/ojphi Published 2014 Apr 29. v6i1.5083.CrossRefPubMedCentral

22.

WHO. Joint External Evaluation of IHR Related core capacities of Republic of Iraq. 2019 [cited 2019 28 July]; Available from: https://www.who.int/ihr/publications/WHO-WHE-CPI-2019.61/en/.

23.

Al Serouri A, Jumaan A, Alkohlani A. Yemen field epidemiology training programme: a tool for strengthening the public health workforce. East Mediterr Health J. 2018;24(9):905–13. https://doi.org/10.26719/2018.24.9.905.CrossRefPubMed

24.

Yemen FETP. Y-FETP Launches its Fourth Cohort of Advanced Field Epidemiology Training. 2017 [cited 2019 18 July]; Available from: http://emphnet.net/?country_programs=yemen-fetp.

25.

Dureab F, Al Awlaqi S, Jahn A. COVID-19 in Yemen: preparedness measures in a fragile state. Lancet Public Health 2020; DOI: https://doi.org/https://doi.org/10.1016/S2468-2667(20)30101-8, 5, 6, e311.

26.

World Medical Association. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. 2013 [cited 2019 25 March]; Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/.

27.

WMA, World Medical Association Declaration Of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373–4.

Title: Mind the gap: an analysis of core capacities of the international health regulations (2005) to respond to outbreaks in Yemen
Authors: Hanan Noman
Fekri Dureab
Iman Ahmed
Abdulwahed Al Serouri
Taha Hussein
Albrecht Jahn
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Public Health
COVID-19
Published in: BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-021-06395-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Out-of-pocket costs and time spent attending antenatal care services: a case study of pregnant women in selected rural communities in Zinder, Niger

Disparities in outpatient and inpatient utilization by rural-urban areas among older Mongolians based on a modified WHO-SAGE instrument

Experiences of psychiatrists and support staff providing telemental health services to Indigenous peoples of Northern Quebec

Health care manager commitment towards implementation of citizen charter standards and associated factors in public hospitals of Jimma zone, Southwest Ethiopia

Comparison of the impact of two national health and social care integration programmes on emergency hospital admissions

An explorative study of factors associated with treatment in specialized mental health care centers among GP patients in Norway