Alexandra B. Stone, PhD, MSc, is Senior Advisor for Assessment, Monitoring, and Evaluation, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD.
Alden L. Weg, MD, MPH, is Director, Combatant Command Support, Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD.
Health Secur. 2022 Jul-Aug;20(4):321-330. doi: 10.1089/hs.2021.0209. Epub 2022 Jul 26.
The International Health Regulations 2005 (IHR) set standards for countries to detect and respond to public health threats such as COVID-19. The US Department of Defense engages with partner nations to build IHR-related health security capacities. In this article, we compare 2 elements of the IHR Monitoring and Evaluation Framework to determine if they align in a useful way. The version of the State Party Self-Assessment Annual Reporting (SPAR) tool used for this study is a self-assessment of 13 capacities, while the Joint External Evaluation (JEE) requires collaboration with international subject matter experts to evaluate 19 capacities. The SPAR indicators are scored separately from 0% to 100%, whereas the JEE uses a rank-ordered scale from 1 to 5 for variable numbers of indicators in each capacity. Using 2018-2019 data from the World Health Organization, we quantitatively and qualitatively evaluated the alignment of the SPAR and JEE scoring systems, using paired tests for related capacities and 3 approaches to matching the scales. Whether using a simple, evenly divided scale for the SPAR or downscaling the SPAR scores to match with lower JEE scores, the paired tests indicate that the JEE and SPAR scoring systems are not aligned. Many of the capacities in the JEE and SPAR are defined differently, pointing to one of the reasons for the discordance. We discuss implications for revision of the JEE and SPAR assessment tools along with ways in which the scores might be used for planning global health engagement capacity-building activities.
《国际卫生条例(2005)》为各国设定了检测和应对 COVID-19 等公共卫生威胁的标准。美国国防部与伙伴国家合作,建立与《国际卫生条例》相关的卫生安全能力。在本文中,我们比较了《国际卫生条例》监测和评估框架的两个要素,以确定它们是否以有用的方式对齐。用于本研究的缔约国年度自我评估报告(SPAR)工具的版本是对 13 项能力的自我评估,而联合外部评估(JEE)要求与国际主题专家合作,以评估 19 项能力。SPAR 指标的得分从 0%到 100%单独评分,而 JEE 使用从 1 到 5 的等级排序,用于每个能力中的可变数量的指标。使用世界卫生组织 2018-2019 年的数据,我们使用相关能力的配对检验和 3 种匹配量表的方法,对 SPAR 和 JEE 评分系统的对齐情况进行了定量和定性评估。无论是对 SPAR 使用简单、平均划分的量表,还是对 SPAR 分数进行降级以与较低的 JEE 分数匹配,配对检验都表明 JEE 和 SPAR 评分系统不匹配。JEE 和 SPAR 中的许多能力的定义不同,这是不匹配的原因之一。我们讨论了修订 JEE 和 SPAR 评估工具的意义,以及如何使用这些分数来规划全球卫生参与能力建设活动。