Using exercises to improve public health preparedness in Asia, the Middle East and Africa

Abstract

BackgroundExercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries.ResultsWe developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel.ConclusionsThese experiences suggest that exercises can be a valuable, low-burden tool to improve emergency preparedness and response in countries around the world. They also demonstrate that countries can work together to develop and conduct successful exercises designed to improve regional preparedness to public health threats. The development of standardized evaluation methods for exercises may be an additional tool to help focus the actions to be taken as a result of the exercise and to improve future exercises. Exercises show great promise as tools to improve public health preparedness across sectors and countries.

Preparedness and response against diseases with epidemic potential in the European Union: a qualitative case study of Middle East Respiratory Syndrome (MERS) and poliomyelitis in five member states

“…Such a platform does not, however, exist for respiratory diseases. Conducting cross-border simulation exercises during 'peacetime' was therefore seen as one way of developing the requisite networks and contacts to ensure good levels of preparedness and response for such diseases [46]. Since exercises can be costly, a legal framework is found in Article 4 of EU Decision 1082 that could be used to leverage funds to support them.…”

Challenges of Premarital Education Program in Iran

“…One of the challenges of premarital education program in Iran is the insufficient allocation of financial resources [16,19,20].Today, the management of financial resources is the most essential tool for achieving the goals and effectiveness of programs in any organization [21].Management of financial resources is one of the four fundamental functions of the healthcare system [22] and optimal provision of health services needs sufficient and justice-based financial resources [23]. Fair allocation of resources is one of the most important challenges of any healthcare system and the main part of the decision-making process, which can hinder the execution and success of organized empowerment healthcare programs [24]. Human resource management and its importance in educating marrying couples were considered in some studies in the present review [25 -29].…”

Planning and preparing for public health threats at airports

“…Emergency preparedness should be a multisector activity and take into account the vulnerabilities, infrastructure and capabilities of a country or region’s health systems [ 21 ]. Importantly, exercises bring together individuals representing organisations with different roles and perspectives [ 23 ] allowing them to identify each other’s capabilities and limitations, and problem-solve about how to address the gaps and overlaps in a low-threat collaborative setting [ 28 ]. The benefits of engaging in multisectoral exercises include a raised awareness of public health threats, identification of priorities and improved working relationships between agencies [ 23 ].…”

“…Importantly, exercises bring together individuals representing organisations with different roles and perspectives [ 23 ] allowing them to identify each other’s capabilities and limitations, and problem-solve about how to address the gaps and overlaps in a low-threat collaborative setting [ 28 ]. The benefits of engaging in multisectoral exercises include a raised awareness of public health threats, identification of priorities and improved working relationships between agencies [ 23 ]. Post-exercise review meetings and reports allow for sharing of the subjective experience of the participants and agencies, and objective measures against predetermined exercise aims.…”

“…Exercises include the identification of possible scenarios based on the probability of hazards and the vulnerability of populations as a basis for planning [ 21 ] and have been shown to be a useful tool to measure preparedness efforts [ 22 , 23 ]. The absence of actual testing is likely to negate even the best of abstract plans [ 21 , 24 ].…”