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Review
, 19 (1), 954

Establishing a Theoretical Foundation for Measuring Global Health Security: A Scoping Review

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Review

Establishing a Theoretical Foundation for Measuring Global Health Security: A Scoping Review

Sanjana J Ravi et al. BMC Public Health.

Abstract

Background: Since the 2014-2016 West Africa Ebola epidemic, the concept of measuring health security capacity has become increasingly important within the broader context of health systems-strengthening, enhancing responses to public health emergencies, and reducing global catastrophic biological risks. Efforts to regularly and sustainably track the evolution of health security capabilities and capacities over time - while also accounting for political, social, and environmental risks - could help countries progress toward eliminating sources of health insecurity. We sought to aggregate evidence-based principles that capture a country's baseline public health and healthcare capabilities, its health security system performance before and during infectious disease crises, and its broader social, political, security, and ecological risk environments.

Methods: We conducted a scoping review of English-language scholarly and gray literature to identify evidence- and practice-based indicators and proxies for measuring health security at the country level over time. We then used a qualitative coding framework to identify recurrent themes in the literature and synthesize foundational principles for measuring global health security. Documents reviewed included English-language literature published after 2001 until the end of the research period-September 2017-to ensure relevance to the current global health security landscape; literature examining acute infectious disease threats with potential for transnational spread; and literature addressing global health security efforts at the country level.

Results: We synthesized four foundational principles for measuring global health security: measurement requires assessment of existing capacities, as well as efforts to build core public health, healthcare, and biosecurity capabilities; assessments of national programs and efforts to mitigate a critical subset of priority threats could inform efforts to generate useful metrics for global health security; there are measurable enabling factors facilitating health security-strengthening efforts; and finally, measurement requires consideration of social, political, and ecological risk environments.

Conclusion: The themes identified in this review could inform efforts to systematically assess the impacts and effectiveness of activities undertaken to strengthen global health security.

Keywords: Assessment; Global health security; Measurement; Public health.

Conflict of interest statement

The authors declare that they have no competing interests.

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References

    1. World Health Organization . Report of the Ebola interim assessment panel. Geneva, Switzerland: World Health Organization; 2015.
    1. Schoch-Spana Monica, Cicero Anita, Adalja Amesh, Gronvall Gigi, Kirk Sell Tara, Meyer Diane, Nuzzo Jennifer B., Ravi Sanjana, Shearer Matthew P., Toner Eric, Watson Crystal, Watson Matthew, Inglesby Tom. Global Catastrophic Biological Risks: Toward a Working Definition. Health Security. 2017;15(4):323–328. - PMC - PubMed
    1. Harvard Global Health Institute, National Academy of Medicine. Monitoring Global Health Security and Pandemic Preparedness. Boston, Massachusetts. 2017.
    1. The National Academies of Sciences, Engineering, and Medicine. The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises. Washington, DC. 2016.
    1. Chatham House. Global Health crises: monitoring and reporting Progress towards preparedness; 2017. Available from: https://www.chathamhouse.org/about/structure/global-health-security/global-health-crises-monitoring-and-reporting-progress-towards-preparedness-project. 2018.
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