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Joint External Evaluation in Ghana – experiences from the field

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Photo: NIPH

At the request of Ghana, and in order to be able to build a national action plan for the improvement of health systems in Ghana, a Joint External Evaluation was conducted in February 2017 in Accra.


How the JEE process work

The JEE process supports countries to implement the International Health Regulations (IHR) through providing information about the strengths and weaknesses in countries’ health security capacities. The evaluation is meant to be used to develop a multi-sectoral country plan for implementation of IHR (2005).

The JEE process is voluntary. Countries undergoing an assessment are committed to developing a plan for strengthening IHR core capacities based on the findings of the assessment. Through the Global Health Preparedness Programme (GHPP), Norway has contributed to assessments by sending technical experts in the field for evaluations. In addition, the Norwegian Institute of Public Health provides competence and shares experiences with partners to help close gaps identified through the JEE or other evaluating tools in four countries – Malawi, Palestine, Moldova and Ghana.


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The gaps in the national systems for preparedness and response need to be thoroughly mapped in order to be able to build a national action plan for the improvement of health systems in any country. 

A method for this is the Joint External Evaluation (JEE) tool that is based on the evaluation process developed in the framework of the Global Health Security Agenda (GHSA). The World Health Organization WHO started using the JEE tool in February 2016. 

The JEE process is voluntary

In Ghana the process was initiated at the request of the country. A Joint External Evaluation was conducted from 6 to 10 February, 2017 in Accra. WHO was responsible for the coordination and technical support of the JEE mission.

The team participating in Ghana was drawn from a roster of international experts identified independently for their expertise and availability to join the mission. The Norwegian Global Health Preparedness Programme sent an expert to participate in the evaluation. In addition, experts from the following five organisations contributed to the JEE mission in Ghana:

  • WHO (Headquarters and Regional Office)
  • the United States Centers for Disease Prevention and Control (US CDC)
  • the German Development Cooperation (GIZ)
  • the Japanese Development Cooperation (JICA)
  • the Food and Agriculture Organization of the United Nations (FAO).

A multisectoral approach

The JEE process employs a multisectoral approach by both the external teams and the host countries. Transparency and openness of data and information sharing is promoted.

The JEE process required that the country first scored the different core capacities themselves, prior to the arrival of the external experts in Accra. This self assessment constituted the main part of the evaluation. Following this, an external team reviewed the results of the self-assessment and conducted additional investigations to support the country’s own results.

Main findings

The main findings of the evaluation in Ghana demonstrated that the country has many well-established mechanisms in place to ensure the detection, prevention and response to public health events. Several areas require strengthening, including multisectoral collaboration as part of a One Health approach, recognising that health is related to the health of animals and the environment, to public health, specimen referral networks and hazard-specific preparedness and response plans for chemical and radiation events.

The full results of the JEE assessment in Ghana are available in the JEE report – Joint External Evaluation of IHR Core Capacities REPUBLIC OF GHANA (pdf).

Follow-up

The Norwegian Institute of Public Health through the GHPP will work closely with the WHO Country Office and Ghana Health Service to support mechanisms to close the identified gaps. Countries undergoing an assessment are committed to developing a plan for strengthening IHR core capacities based on the findings of the assessment.

The activities included in the GHPP partnership in Ghana will address key gaps identified during the assessment process, including GHPP-team and the US CDC-team visiting the University of Ghanas FETP programme staff as part of follow-up after the JEE.