El-Jardali Fadi, Kanth Priyanka D, Nguyen Son-Nam, Varkey Sherin, Duran Denizhan, Menon Rekha, Fadlallah Racha, Malek Ammar, Jain Vageesh, Saleh Majd, Buback Laura, Reid Michael
American University of Beirut, Beirut, Lebanon.
World Bank, Washington, District of Columbia, USA
BMJ Glob Health. 2025 Aug 11;10(8):e016459. doi: 10.1136/bmjgh-2024-016459.
Middle East and North Africa (MENA) region has been one of the most significantly impacted by the COVID-19 pandemic. The escalating frequency and complexity of global health threats-from pandemics like COVID-19 to climate change-induced emergencies-have elevated the imperative for stronger and more resilient health systems in the MENA region and the world over. In this paper, we introduce a tool designed to offer a comprehensive and engaging approach to assessing health system resilience and emergency preparedness and response capabilities, and articulate the tool's value add in the MENA region.
We developed the tool following a three-step approach consisting of (1) definition of purpose and scope of tool, (2) item generation and reduction and (3) testing for content and face validity given the MENA region's context. The Health System Resiliency Analysis Framework was adapted as the guiding framework for tool development.
The tool offers a comprehensive and adaptable approach to self-assessment of health system resilience, using a multisectoral platform that enables continuous learning and improvement. The novelty of the tool resides in its potential to yield practical priority actions that need to be considered at all levels. The current version of the tool includes five components: (1) financing arrangements; (2) governance arrangements; (3) health system resources, public health and service delivery; (4) data and information systems; and (5) political and socioeconomic context. Each of the components consists of various subcomponents (22 in total). Each subcomponent is assessed using a mix of quantitative and qualitative indicators (99 indicators in total). On that basis, each subcomponent is scored to reflect the maturity of the country's capacity in that specific area.
The proposed tool will address the limitations of the existing assessment instruments. We invite others to contribute with additional real-life implementation of the tool.
中东和北非地区是受新冠疫情影响最严重的地区之一。从新冠疫情这样的大流行到气候变化引发的紧急情况，全球卫生威胁的频率和复杂性不断升级，这凸显了中东和北非地区乃至全世界建立更强大、更具韧性的卫生系统的紧迫性。在本文中，我们介绍一种工具，旨在提供一种全面且引人入胜的方法来评估卫生系统的韧性以及应急准备和应对能力，并阐明该工具在中东和北非地区的附加价值。
我们采用三步法开发该工具，包括：（1）确定工具的目的和范围；（2）生成并精简项目；（3）根据中东和北非地区的情况进行内容和表面效度测试。卫生系统韧性分析框架被用作工具开发的指导框架。
该工具提供了一种全面且可适应的卫生系统韧性自我评估方法，使用一个多部门平台，实现持续学习和改进。该工具的新颖之处在于它有潜力产生各级都需要考虑的实际优先行动。该工具的当前版本包括五个组成部分：（1）融资安排；（2）治理安排；（3）卫生系统资源、公共卫生和服务提供；（4）数据和信息系统；（5）政治和社会经济背景。每个组成部分由多个子组成部分（共22个）构成。每个子组成部分使用定量和定性指标相结合的方式进行评估（总共99个指标）。在此基础上，对每个子组成部分进行评分，以反映该国在该特定领域的能力成熟度。
所提议的工具将解决现有评估工具的局限性。我们邀请其他人通过该工具的更多实际应用做出贡献。
