NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NATIONAL ACTION PLAN FOR HEALTH SECURITY INTERNATIONAL HEALTH REGULATIONS (2005) NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NAPHS NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/ igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use Design: crayonbleu.com - +33 (0)47 261 0999 WHO/WHE/CPI/2018.52 INTERNATIONAL HEALTH REGULATIONS (2005) 5 - A 3 step strategic framework for NAPHS The World Health Organization (WHO) would like to express sincere gratitude to all those who contributed to the development of the ‘NAPHS for All’ framework. The framework was guided by the outcomes of a global review on the methodology and process of planning for health security in countries. Country level health planning experiences from the past one year have been main driving force to develop this framework and guidance to facilitate health security planning in countries. WHO developed this document with the support of member countries, partners and all the regional offices and other departments of WHO headquarters. This document was finalized by Dr Nirmal Kandel, Dr Lucy Boulanger, Dr Jostacio Lapitan, Dr Qudsia Huda and Dr Stella Chungong, with contributions from their colleagues – Mr Jonathan Abrahams, Mr Frederik Copper, Dr Stéphane De La Rocque, Dr Rajesh Sreedharan, Mr Ludy Suryantoro, Mr Glen Lolong, Dr Benjamin Lane and Ms Romina Stelter – at WHO headquarters. Special thanks go to Dr Ambrose Talisuna, Dr Ali Yahaya, Dr Antonio Oke, Dr Gyanendra Gongal, Mr Nicolas Isla, Dr Dalia Samhouri, Dr Roberta Andraghetti and Mr Vasily Esenamanov, for providing inputs from WHO regional offices. WHO is grateful to the following partners who provided technical and financial assistance in the process: • Food and Agriculture Organization of the United Nations (FAO) • World Organization for Animal Health (OIE) • Centers for Disease Control and Prevention (US CDC) • Public Health England (PHE) • Resolve to Save Lives ACKNOWLEDGEMENT INTERNATIONAL HEALTH REGULATIONS (2005) 6 - A 3 step strategic framework for NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) 7 - A 3 step strategic framework for NAPHS ACKNOWLEDGEMENT 5 1. INTRODUCTION 9 2. PURPOSE OF THE FRAMEWORK 10 3. SCOPE OF THE FRAMEWORK 10 4. GUIDING PRINCIPLES 10 5. TARGET AUDIENCE 11 6. TIMEFRAME 11 7. STEPS OF PLANNING 11 8. CRITICAL COMPONENTS OF A COMPLETED NAPHS DOCUMENT 12 8.1 STEP 1: INCEPTION 13 Review of plans and capacity assessments 13 Stakeholder analysis 13 SWOT analysis 13 Prioritization of technical areas 13 8.2 STEP 2: DEVELOPMENT 14 Prioritization of activities 14 Monitoring & evaluation 14 Costing and mapping resources 14 Approval and endorsement 14 8.3 STEP 3: IMPLEMENTATION 15 Reprioritization for implementation 15 Integrating into national development planning 15 Monitoring, evaluation and reporting 15 Periodic review and update 15 CONTENTS INTERNATIONAL HEALTH REGULATIONS (2005) 8 - A 3 step strategic framework for NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) 9 - A 3 step strategic framework for NAPHS 1. INTRODUCTION Lessons learned from Ebola virus disease, Zika virus disease and other health emergencies have highlighted the need for countries to continuously develop, strengthen and maintain their capacities under the International Health Regulations (2005) (IHR). In particular, they must establish evidence-based capacities to prevent, prepare for, detect, notify, and respond to acute public health emergencies and events. Strengthening these capacities not only improves national health security but also safeguards travel and trade, and helps to protect economic and social development. Developing capacities for health security in a country requires involvement of public and private entities from a range of sectors including health, agriculture, environment, finance, security, emergency management, education, and transportation. The World Health Organization (WHO) is mandated through various resolutions, decisions and reports of the World Health Assembly and in the IHR to provide technical guidance and support to its Member States for strengthening their health systems including IHR capacities at the national, subnational and local levels. Preparedness for health emergencies was identified as one of the three strategic priorities in the WHO’s thirteenth general programme of work 2019–2023 (GPW 13). The programme aims to achieve “one billion protected from health emergencies”. The WHO Secretariat in consultation with Member States developed the IHR monitoring and evaluation framework (IHRMEF) in line with the recommendations of the review committee on second extensions for establishing national public health capacities and on IHR implementation1. The IHRMEF objectively informs national action plans to strengthen country capacities for public health emergency preparedness and health security. The IHRMEF has four components: mandatory annual reporting, and the voluntary after-action review, simulation exercises and voluntary external evaluation including the joint external evaluation. The national action planning process transforms recommendations from various evaluations into actions that can strengthen the ability of countries to prepare and be operationally ready to manage major public health risks or events. National Action Plan for Health Security (NAPHS) is a country owned, multi-year, planning process that can accelerate the implementation of IHR core capacities, and is based on with One Health and whole-of-government approach for all hazards. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. The NAPHS also provides an overarching process to capture all ongoing preparedness initiatives in a country along with a country’s governance mechanism for emergency and disaster risk management. The planning process should leverage other planning processes, such as antimicrobial resistance (AMR) and pandemic preparedness, etc2. Since 2016, WHO has been working closely with many countries and partners to support the development and implementation of NAPHS. Using feedback from countries, regions and partners, WHO developed this framework to consolidate technical guidance to countries for NAPHS development and implementation. The framework provides guidance to identify: (i) evidence-based priority actions that can be implemented quickly to have immediate impact, and (ii) long-term actions for sustainable capacity development to improve IHR capacities for health security and health systems. 1 - WHA Resolution 64.10, WHA resolution 65.20, WHA resolution 68.5, WHA Report A69/21, accessed 21 December 2018 2 - http://www.who.int/antimicrobial-resistance/national-action-plans/manual/en/, accessed 21 December 2018 INTERNATIONAL HEALTH REGULATIONS (2005) 10 - A 3 step strategic framework for NAPHS 2. PURPOSE OF THE FRAMEWORK 4. GUIDING PRINCIPLES 3. SCOPE OF THE FRAMEWORK The NAPHS framework is a flexible, three-step approach to help countries plan and implement priority actions to attain health security. It builds on and refers to all existing policies, agreements, strategies and frameworks at the national, regional and global levels and is designed to be used by countries to facilitate multisectoral planning. The framework emphasizes the importance of alignment and integration with the country’s national health strategic plan as well as other relevant national sectoral plans in the development and implementation of NAPHS. Countries have the prerogative to select and choose the steps/ actions/components of the framework for the development and implementation of NAPHS based on their context. The NAPHS framework provides three-step approach -(i) inception, (ii) development, and (iii) implementation- for countries to: • focus on multisectoral efforts to identify national priorities using all relevant plans for health security (such as, national health sector plan, plans for emergency preparedness, response, and recovery, pandemic influenza preparedness plan, plans for AMR, laboratory, One Health); Leadership: Country-led, dynamic, adaptable to country context, with WHO technical support. Approach: One Health, whole-of-government approach for all-hazards, risk-based planning for health security. Health emergencies weaken health systems and the weak health systems amplify emergencies. Strengthening the IHR implementation through the NAPHS only prepare and strengthens the health systems' capacities to prevent, detect and respond to public health risks and events. The national action plan for health security is built on the essential public health functions for prevention, prepare for, detection, and response to public health risks or events. The framework provides optional steps and components in the planning process for countries to accelerate • use all existing risk and capacity assessments and evaluations of IHR capacities to identify gaps and provide evidence base action; • generate consensus on priority technical areas of action and detailed activities and assign responsibility; • conduct costing of the NAPHS, facilitate partnership, as well as map and mobilize resources including: - domestic financing – national allocation within the budget cycle of health sector plan; - development funding – development pro- jects, partner support; - disaster – humanitarian funding, recovery projects, contingency fund for emergencies; • prioritize short-term actions for immediate implementation and long-term actions for sustainable capacity development, and embed into existing national health sector plan; and • monitor and evaluate the implementation of NAPHS and report on the status of implementation of the IHR capacities to WHO. Sustainability: Aligned with existing plans relevant to the IHR (i.e., AMR, PIPP) and integrated into the national health sector plan. implementation of priority actions to strengthen health security. It is accompanied by a NAPHS guideline, which provides detailed guidance on each step of the NAPHS framework and includes all the necessary tools and templates to develop and implement a national action plan. The framework is comprehensive and supports preparedness planning for all hazards, risks and events. The framework also allows countries to scale up operational readiness by implementing priority preparedness activities around imminent risks. INTERNATIONAL HEALTH REGULATIONS (2005) 11 - A 3 step strategic framework for NAPHS 5. TARGET AUDIENCE 6. TIMEFRAME 7. STEPS OF PLANNING This framework provides guidance for relevant stakeholders for health security planning and implementation including government, The framework provides guidance on developing a five year strategic plan with annual operational plans. The framework is intended help countries to initiate and complete the planning process within two to six months of finishing a voluntary external evaluation (such as joint external evaluation), by capturing the momentum generated by the evaluation processes. The NAPHS can be triggered by a range of factors including but not limited to assessment findings (such as voluntary external evaluation, simulation exercises, after action reviews, risk assessments, It is the prerogative of the countries to choose when to start, which steps to take, and what optional components and tools to use in each step to fit the country context. Countries may choose to initiate a new planning process or update existing non-government, and private sectors, as well as academia, and the international community. etc.); the IHR annual reporting; routine monitoring and evaluation frameworks; national planning and budget cycle reviews; priorities and policies of the government; and the occurrence of large events. The NAPHS process should be integrated with sectoral planning and budget cycles and must consider existing planning cycle timeframes when establishing the duration of the plans. The NAPHS will be reviewed (such asannually) and updated regularly (such as annually) or as needed (following health emergencies). plans based on the local context. The described components of the steps provide guidance on inputs and outputs and are not intended to be sequential. INCEPTION IMPLEMENTATION • Review of existing capacity assessments • Stakeholders analysis • SWOT analysis • Prioritization of areas of action • Reprioritization for implementation • Integrating into national development planning • Monitoring, evaluation and reporting • Periodic review and update DEVELOPMENT • Identification and prioriti- zation of activities (matrix) • Monitoring and evaluation • Costing & mapping resources • Approval and endorsement Situation analysis of country context Multisectoral steering group Draft NAPHS Resource map Plan implemented M&E and reporting NAPHS FRAMEWORK Step 1 – Inception consists of a desktop review of all existing national plans and capacity assessments, stakeholder analysis, SWOT analysis and prioritization of technical areas of action (based on various assessments, existing plans and various national, regional and global strategies). A prioritization exercise can consider strategic costing using a rapid costing tool. INTERNATIONAL HEALTH REGULATIONS (2005) 12 - A 3 step strategic framework for NAPHS Outputs of this step may include: • a situation analysis of the country context, and • an agreement of a governance structure to provide strategic direction to the planning process, such as a high-level, multisectoral steering group. Step 2 – Development consists of identification and prioritization of activities within the technical areas based on risk assessment, monitoring and evaluation framework, detailed costing of activities, mapping resources and endorsement of the plan. Outputs of this step may include: • an approved multi-year, costed national action plan for health security, and • a resource map to provide information on available resources and gaps. Step 3 – Implementation consists of reprio- ritization of the plan for operations based on resource mapping, integration into the national health sector plan, monitoring, evaluation, and periodical reporting and updating of the plan. This step includes implementation of the plan and continued mobilization of additional resources. Outputs of this step may include: • a monitoring, evaluation and reporting process, and • implementation of the plan. 8. CRITICAL COMPONENTS OF A COMPLETED NAPHS DOCUMENT Depending on the strategic approach taken by the country, a completed NAPHS document should have three major parts: 1. A narrative summary containing the situation analysis and a summary of strategic and operational parts of the NAPHS including priority technical areas, costing, overview with a communication strategy and an implementation plan with a process to report. 2. A planning matrix containing detailed priority activities with costing, and mapped resources. 3. Annexes containing all national plans and assessments relevant to the IHR, terms of reference of national multisectoral steering, and technical groups, a stakeholder inventory, the communication strategy, and the imple- mentation plan with the monitoring and process. INTERNATIONAL HEALTH REGULATIONS (2005) 13 - A 3 step strategic framework for NAPHS 8. 1 ST EP 1 : I N CE PT IO N CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS R ev ie w o f p la ns an d ca pa ci ty as se ss m en ts Fo rm a t ea m f ro m k ey h ea lth p ro gr am m es ( su ch a s di se as e co nt ro l, em er ge nc y, et c. ), he al th po lic y, pl an ni ng an d fin an ce un its /d ep ar tm en ts /m in is tr ie s to re vi ew a ll av ai la bl e as se ss m en ts re la te d to h ea lth s ec ur ity . • R is k as se ss m en t o r p ro fil e (S TA R ) • A ss es sm en ts ( SP AR , v ol un ta ry e xt er na l e va lu at io n, Si m Ex , A AR , I H R- PV S) • P la ns , s tr at eg ie s (N H SP , N D P, A M R, P IP P, O H P) , • R eg io na l a gr ee m en ts • C om m un ic at io n an d st ra te gi es Te m pl at e fo r s itu at io n an al ys is S ta ke ho ld er an al ys is Id en tif y m an da te s an d ro le s th ro ug h m ap pi ng st ak eh ol de rs (g ov er nm en t, no n- go ve rn m en t an d m ov in g to w ar ds a s tr at eg ic pa rt ne rs hi p fo r i m pl em en ta tio n. • G ov er nm en t a nd n on -g ov er nm en t s tr at eg ie s re la te d to h ea lth s ec ur ity (m in is tr ie s, W H O, U H C, S D G , U N ) • D ev el op m en t a nd h um an ita ria n pr io rit ie s (C CS , C SA , U N D AF ) St ak eh ol de r a na ly si s te m pl at e S W O T an al ys is Id en tif y ch al le ng es a nd o pp or tu ni tie s fo r pl an ni ng a nd i m pl e- m en ta tio n. • D es k re vi ew a nd s ta ke ho ld er a na ly se s • S um m ar y of s ec to ra l s tr at eg ie s an d pl an s SW O T an al ys is to ol P ri or iti za tio n of te ch ni ca l a re as M ap t he h ea lth s ec ur ity e le m en ts f ro m d es k re vi ew , de te rm in e w he th er a dd iti on al te ch ni ca l a re as fo r a ct io n ar e ne ed ed , p rio rit iz e th e te ch ni ca l a re as fo r a ct io n an d co ns id er s tr at eg ic c os t e st im at es us in g a ra pi d co st in g to ol . • D es k re vi ew , S W O T an d st ak eh ol de r a na ly se s P rio rit iz at io n gu id e O U TP U TS Si tu at io n an al ys is A s itu at io n an al ys is p ro vi de s ba se lin e in fo rm at io n fo r p la nn in g, in cl ud in g th e co un tr y’ s ris k pr ofi le , c ap ac iti es a nd p rio rit y ga ps in th e pr es en t s ys te m to p re ve nt , p re pa re fo r, de te ct a nd re sp on d to h ea lth ri sk s an d ev en ts . I t d efi ne s st ra te gi c ob je ct iv es , p rio rit y ac tio ns a nd a re as o f w or k w ith a ch ie va bl e go al s. It ta ke s in to a cc ou nt th e co un tr y co nt ex t. M ul tis ec to ra l st ee rin g gr ou p H ig h le ve l, m ul tis ec to ra l s te er in g gr ou p or s im ila r ex is tin g pl at fo rm t o gu id e an d di re ct t he p la nn in g pr oc es s an d en su re t ha t it is e nd or se d an d ap pr ov ed a cr os s al l r el ev an t se ct or s an d ad vo ca te d fo r at t he h ig he st le ve l n ec es sa ry f or in te r- m in is te ria l a nd p ar lia m en ta ry c om m itm en t. It w ill al so g ui de th e im pl em en ta tio n pl an ni ng a nd p ro gr am m e m an ag em en t s tr uc tu re n ee de d to o ve rs ee im pl em en ta tio n as w el l a s th e m on ito rin g an d ev al ua tio n pr oc es s. INTERNATIONAL HEALTH REGULATIONS (2005) 14 - A 3 step strategic framework for NAPHS 8. 2 ST EP 2 : D EV EL O PM EN T CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS P ri or iti za tio n of ac tiv iti es Te ch ni ca l w or ki ng g ro up s de ve lo p an d po pu la te a m at rix o f ac tiv iti es , r es po ns ib le a ge nc ie s, ti m el in es a s w el l a s in di ca to rs an d pr io rit iz e th em a cc or di ng t o re su lts f ro m t he s itu at io n an al ys is . • S itu at io n an al ys is Pl an ni ng a nd c os tin g to ol W H O b en ch m ar k to ol P rio rit iz at io n gu id e M on ito ri ng & ev al ua tio n A cr os s- se ct or al m on ito rin g an d ev al ua tio n fr am ew or k fo r N AP H S im pl em en ta tio n ag re ed u po n by t ec hn ic al w or ki ng gr ou ps s im ul ta ne ou sl y w ith a ct iv ity d ev el op m en t. • E xi st in g na tio na l m on ito rin g an d ev al ua tio n pr oc es s • N at io na l b en ch m ar ks a nd in di ca to rs • I H R, S D G , a nd S en da i i nd ic at or s M on ito rin g an d ev al ua tio n G ui de C os tin g an d m ap pi ng re so ur ce s Ca lc ul at e th e co st o f im m ed ia te a nd l on ge r- te rm p rio rit y ac tio ns u si ng b en ch m ar ks a nd /o r t he c os t o f s pe ci fic a ct iv iti es us in g de ta ile d co st in g to ol . Id en tif y re so ur ce s av ai la bl e fr om bo th do m es tic an d in te rn at io na l so ur ce s an d fil l up po te nt ia l ga ps fo r th e im pl em en ta tio n of N AP H S. A lig n w ith n at io na l s ec to ra l b ud ge ts an d re so ur ce s fo r s us ta in ab ili ty . • G ov er nm en t b ud ge t g ui de lin es • M oH , M oF , N D M C an d ot he r re le va nt m in is tr ie s, CC A, C CS , U N D AF , H RP • S ec to ra l b ud ge ts , s tr at eg ie s an d fu nd in g m ec ha ni sm s C ou nt ry ’s c os tin g pr oc es s Pl an ni ng a nd c os tin g to ol A pp ro va l a nd en do rs em en t A ro bu st N AP H S re qu ire s hi gh le ve l m ul tis ec to ra l e nd or se m en t. M ul tis ec to ra l w or ks ho ps , d is se m in at io n an d co m m un ity le ve l ou tr ea ch a re re co m m en de d. S en io r g ov er nm en t o ffi ci al s sh ou ld ta ke p ar t i n th e re le as e an d la un ch o f t he N AP H S. • R ev is ed N AP H S O U TP U TS Re so ur ce m ap A re so ur ce m ap th at d oc um en ts d om es tic fu nd in g so ur ce s, a nd a ny e xi st in g, e xt er na l f un di ng re so ur ce s, a nd fu nd in g ga ps in th e dr af t N AP H S. En do rs ed N AP H S A n en do rs ed N A P H S th at is c os te d an d pr io rit iz ed ; a s w el l a s al ig ne d to e xi st in g st ra te gi es w ith a d efi ne d m on ito rin g an d ev al ua tio n pr oc es s an d pr og ra m m e m an ag em en t s tr uc tu re th at c an c on tin uo us ly re vi ew a nd u pd at e th e ac tiv iti es a nd p la n. A su m m ar y of th e dr af t i s in cl ud ed in th e na rr at iv e pa rt o f t he N AP H S. INTERNATIONAL HEALTH REGULATIONS (2005) 15 - A 3 step strategic framework for NAPHS 8. 3 ST EP 3 : I M PL EM EN TA TI O N CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS R ep ri or iti za tio n fo r im pl em en ta tio n R ep rio rit iz at io n an d se qu en ci ng o f a ct iv iti es b as ed o n al lo ca tio n of a va ila bl e an d po te nt ia l r es ou rc es , a nd o ng oi ng a ct iv iti es . • Fi na l N AP H S • Re so ur ce m ap • Pr io rit y m at rix • Co st in g m at rix P rio rit iz at io n gu id e In te gr at in g in to n at io na l de ve lo pm en t pl an ni ng Th e st ee rin g gr ou p en su re s th at t he N AP H S in te gr at es i nt o ex is tin g se ct or al s tr at eg ie s an d do m es tic b ud ge ta ry p la nn in g an d fin an ci ng , em er ge nc y pl an s an d ot he r in te rn at io na l or re gi on al f ra m ew or ks w ith c on tin uo us r es ou rc e m ob ili za tio n to fil l t he g ap s. • S ec to ra l s tr at eg ie s (N H SP , H RP , E PR P) • N at io na l e m er ge nc y m an ag em en t p la ns • E xt er na l f ra m ew or ks M on ito ri ng , ev al ua tio n an d re po rt in g Th e st ee rin g gr ou p de ve lo ps th e op er at io na l pl an fo r im pl em en ta tio n w ith a gr ee d pr og ra m m e m an ag em en t, in cl ud in g ro le s an d re sp on si bi lit ie s of i m pl em en tin g st ak eh ol de rs . It sp ec ifi es a m on ito rin g an d ev al ua tio n fr am ew or k th at is co m pa tib le w ith e xi st in g na tio na l s ys te m s. • N at io na l m on ito rin g an d ev al ua tio n re po rt s • N AP H S m on ito rin g an d ev al ua tio n re po rt s • A ct iv ity re po rt s • I H R m on ito rin g an d ev al ua tio n re po rt s N AP H S m on ito rin g an d ev al ua tio n gu id e P er io di c re vi ew an d up da te Pe rio di c re vi ew a nd u pd at e is e st ab lis he d w hi ch d es cr ib es ho w m aj or o bj ec tiv es a re u pd at ed a nd d oc um en ts a re co rd o f ch an ge s. • F in al N AP H S O U TP U TS Pl an im pl em en te d Th e N A P H S th at is a pp ro ve d by th e re sp ec tiv e au th or iti es in c ou nt ry a im s at ta rg et s to re ac h in th e ne xt fi ve y ea rs . T hi s N A P H S al so h as b uy -i n of a ll re le va nt s ta ke ho ld er s an d is s ha re d w ith a ll th e re le va nt s ta ke ho ld er s. Th is id en tifi es e nt ry p oi nt s in to th e na tio na l b ud ge t c yc le th ro ug h se ct or al d ev el op m en t p la ns . M on ito rin g, ev al ua tio n an d re po rt in g A n im pl em en ta tio n pl an t ha t id en tifi es e vi de nc e- ba se d pr io rit y ac tiv iti es f or i m m ed ia te i m pl em en ta tio n an d ai m s to a ch ie ve q ui ck r es ul ts i s op er at io na liz ed . T hi s ca n be s up po rt ed b y al l a va ila bl e fu nd in g so ur ce s th ro ug h ex is tin g pl an s in c ou nt rie s, s uc h as h um an ita ria n re sp on se , r ec ov er y, em er ge nc y pr ep ar ed ne ss , i n co un tr ie s. Su m m ar y of th e im pl em en ta tio n pl an to b e in cl ud ed in th e na rr at iv e pa rt o f t he N AP H S. T he N AP H S is im pl em en te d an d m on ito rin g an d ev al ua tio n an d re po rt in g is in iti at ed . AA R= A fte r A ct io n Re vi ew ; CC S= C ou nt ry C oo pe ra tio n St ra te gy ; CC A= C om m on C ou nt ry A ss es sm en t ; E PR P= E m er ge nc y Pr ep ar ed ne ss a nd R es po ns e Pl an ; H RP = ; H SS =H ea lth S ys te m s St re ng th en in g ; I H R- PV S= In te rn at io na l H ea lth Re gu la tio ns – P er fo rm an ce o f V et er in ar y Se rv ic es ; M oF =M in is tr y of F in an ce ; M oH =M in is tr y of H ea lth ; N D M C= N at io na l D is as te r M an ag em en t C en te r ; N D P= N at io na l D is as te r P ro gr am m e ; N H SP = N at io na l H ea lth S ec to r P la n ; O H P= O ne H ea lth P la n; P IP P = P an de m ic In flu en za P re pa re dn es s P la n; S D G =S us ta in ab le D ev el op m en t G oa ls ; S im Ex = Si m ul at io n Ex er ci se s ; S PA R = St at e P ar ty A nn ua l R ep or tin g ; S TA R = W H O to ol fo r s tr at eg ic ri sk a ss es sm en t; U H C =u ni ve rs al he al th c ov er ag e; U N =U ni te d N at io ns ; U N DA F= U ni te d N at io ns D ev el op m en t A ct io n Fr am ew or k. CONTACT COUNTRY CAPACITY MONITORING AND EVALUATION UNIT Country Health Emergency Preparedness and IHR World Health Organization 20 Avenue Appia CH-1211 Geneva Switzerland E-MAIL cme@who.int
NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NATIONAL ACTION PLAN FOR HEALTH SECURITY INTERNATIONAL HEALTH REGULATIONS (2005) NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NAPHS NAPHS FOR ALL A 3 STEP STRATEGIC FRAMEWORK FOR NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/ igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use Design: crayonbleu.com - +33 (0)47 261 0999 WHO/WHE/CPI/2018.52 INTERNATIONAL HEALTH REGULATIONS (2005) 5 - A 3 step strategic framework for NAPHS The World Health Organization (WHO) would like to express sincere gratitude to all those who contributed to the development of the ‘NAPHS for All’ framework. The framework was guided by the outcomes of a global review on the methodology and process of planning for health security in countries. Country level health planning experiences from the past one year have been main driving force to develop this framework and guidance to facilitate health security planning in countries. WHO developed this document with the support of member countries, partners and all the regional offices and other departments of WHO headquarters. This document was finalized by Dr Nirmal Kandel, Dr Lucy Boulanger, Dr Jostacio Lapitan, Dr Qudsia Huda and Dr Stella Chungong, with contributions from their colleagues – Mr Jonathan Abrahams, Mr Frederik Copper, Dr Stéphane De La Rocque, Dr Rajesh Sreedharan, Mr Ludy Suryantoro, Mr Glen Lolong, Dr Benjamin Lane and Ms Romina Stelter – at WHO headquarters. Special thanks go to Dr Ambrose Talisuna, Dr Ali Yahaya, Dr Antonio Oke, Dr Gyanendra Gongal, Mr Nicolas Isla, Dr Dalia Samhouri, Dr Roberta Andraghetti and Mr Vasily Esenamanov, for providing inputs from WHO regional offices. WHO is grateful to the following partners who provided technical and financial assistance in the process: • Food and Agriculture Organization of the United Nations (FAO) • World Organization for Animal Health (OIE) • Centers for Disease Control and Prevention (US CDC) • Public Health England (PHE) • Resolve to Save Lives ACKNOWLEDGEMENT INTERNATIONAL HEALTH REGULATIONS (2005) 6 - A 3 step strategic framework for NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) 7 - A 3 step strategic framework for NAPHS ACKNOWLEDGEMENT 5 1. INTRODUCTION 9 2. PURPOSE OF THE FRAMEWORK 10 3. SCOPE OF THE FRAMEWORK 10 4. GUIDING PRINCIPLES 10 5. TARGET AUDIENCE 11 6. TIMEFRAME 11 7. STEPS OF PLANNING 11 8. CRITICAL COMPONENTS OF A COMPLETED NAPHS DOCUMENT 12 8.1 STEP 1: INCEPTION 13 Review of plans and capacity assessments 13 Stakeholder analysis 13 SWOT analysis 13 Prioritization of technical areas 13 8.2 STEP 2: DEVELOPMENT 14 Prioritization of activities 14 Monitoring & evaluation 14 Costing and mapping resources 14 Approval and endorsement 14 8.3 STEP 3: IMPLEMENTATION 15 Reprioritization for implementation 15 Integrating into national development planning 15 Monitoring, evaluation and reporting 15 Periodic review and update 15 CONTENTS INTERNATIONAL HEALTH REGULATIONS (2005) 8 - A 3 step strategic framework for NAPHS INTERNATIONAL HEALTH REGULATIONS (2005) 9 - A 3 step strategic framework for NAPHS 1. INTRODUCTION Lessons learned from Ebola virus disease, Zika virus disease and other health emergencies have highlighted the need for countries to continuously develop, strengthen and maintain their capacities under the International Health Regulations (2005) (IHR). In particular, they must establish evidence-based capacities to prevent, prepare for, detect, notify, and respond to acute public health emergencies and events. Strengthening these capacities not only improves national health security but also safeguards travel and trade, and helps to protect economic and social development. Developing capacities for health security in a country requires involvement of public and private entities from a range of sectors including health, agriculture, environment, finance, security, emergency management, education, and transportation. The World Health Organization (WHO) is mandated through various resolutions, decisions and reports of the World Health Assembly and in the IHR to provide technical guidance and support to its Member States for strengthening their health systems including IHR capacities at the national, subnational and local levels. Preparedness for health emergencies was identified as one of the three strategic priorities in the WHO’s thirteenth general programme of work 2019–2023 (GPW 13). The programme aims to achieve “one billion protected from health emergencies”. The WHO Secretariat in consultation with Member States developed the IHR monitoring and evaluation framework (IHRMEF) in line with the recommendations of the review committee on second extensions for establishing national public health capacities and on IHR implementation1. The IHRMEF objectively informs national action plans to strengthen country capacities for public health emergency preparedness and health security. The IHRMEF has four components: mandatory annual reporting, and the voluntary after-action review, simulation exercises and voluntary external evaluation including the joint external evaluation. The national action planning process transforms recommendations from various evaluations into actions that can strengthen the ability of countries to prepare and be operationally ready to manage major public health risks or events. National Action Plan for Health Security (NAPHS) is a country owned, multi-year, planning process that can accelerate the implementation of IHR core capacities, and is based on with One Health and whole-of-government approach for all hazards. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. The NAPHS also provides an overarching process to capture all ongoing preparedness initiatives in a country along with a country’s governance mechanism for emergency and disaster risk management. The planning process should leverage other planning processes, such as antimicrobial resistance (AMR) and pandemic preparedness, etc2. Since 2016, WHO has been working closely with many countries and partners to support the development and implementation of NAPHS. Using feedback from countries, regions and partners, WHO developed this framework to consolidate technical guidance to countries for NAPHS development and implementation. The framework provides guidance to identify: (i) evidence-based priority actions that can be implemented quickly to have immediate impact, and (ii) long-term actions for sustainable capacity development to improve IHR capacities for health security and health systems. 1 - WHA Resolution 64.10, WHA resolution 65.20, WHA resolution 68.5, WHA Report A69/21, accessed 21 December 2018 2 - http://www.who.int/antimicrobial-resistance/national-action-plans/manual/en/, accessed 21 December 2018 INTERNATIONAL HEALTH REGULATIONS (2005) 10 - A 3 step strategic framework for NAPHS 2. PURPOSE OF THE FRAMEWORK 4. GUIDING PRINCIPLES 3. SCOPE OF THE FRAMEWORK The NAPHS framework is a flexible, three-step approach to help countries plan and implement priority actions to attain health security. It builds on and refers to all existing policies, agreements, strategies and frameworks at the national, regional and global levels and is designed to be used by countries to facilitate multisectoral planning. The framework emphasizes the importance of alignment and integration with the country’s national health strategic plan as well as other relevant national sectoral plans in the development and implementation of NAPHS. Countries have the prerogative to select and choose the steps/ actions/components of the framework for the development and implementation of NAPHS based on their context. The NAPHS framework provides three-step approach -(i) inception, (ii) development, and (iii) implementation- for countries to: • focus on multisectoral efforts to identify national priorities using all relevant plans for health security (such as, national health sector plan, plans for emergency preparedness, response, and recovery, pandemic influenza preparedness plan, plans for AMR, laboratory, One Health); Leadership: Country-led, dynamic, adaptable to country context, with WHO technical support. Approach: One Health, whole-of-government approach for all-hazards, risk-based planning for health security. Health emergencies weaken health systems and the weak health systems amplify emergencies. Strengthening the IHR implementation through the NAPHS only prepare and strengthens the health systems' capacities to prevent, detect and respond to public health risks and events. The national action plan for health security is built on the essential public health functions for prevention, prepare for, detection, and response to public health risks or events. The framework provides optional steps and components in the planning process for countries to accelerate • use all existing risk and capacity assessments and evaluations of IHR capacities to identify gaps and provide evidence base action; • generate consensus on priority technical areas of action and detailed activities and assign responsibility; • conduct costing of the NAPHS, facilitate partnership, as well as map and mobilize resources including: - domestic financing – national allocation within the budget cycle of health sector plan; - development funding – development pro- jects, partner support; - disaster – humanitarian funding, recovery projects, contingency fund for emergencies; • prioritize short-term actions for immediate implementation and long-term actions for sustainable capacity development, and embed into existing national health sector plan; and • monitor and evaluate the implementation of NAPHS and report on the status of implementation of the IHR capacities to WHO. Sustainability: Aligned with existing plans relevant to the IHR (i.e., AMR, PIPP) and integrated into the national health sector plan. implementation of priority actions to strengthen health security. It is accompanied by a NAPHS guideline, which provides detailed guidance on each step of the NAPHS framework and includes all the necessary tools and templates to develop and implement a national action plan. The framework is comprehensive and supports preparedness planning for all hazards, risks and events. The framework also allows countries to scale up operational readiness by implementing priority preparedness activities around imminent risks. INTERNATIONAL HEALTH REGULATIONS (2005) 11 - A 3 step strategic framework for NAPHS 5. TARGET AUDIENCE 6. TIMEFRAME 7. STEPS OF PLANNING This framework provides guidance for relevant stakeholders for health security planning and implementation including government, The framework provides guidance on developing a five year strategic plan with annual operational plans. The framework is intended help countries to initiate and complete the planning process within two to six months of finishing a voluntary external evaluation (such as joint external evaluation), by capturing the momentum generated by the evaluation processes. The NAPHS can be triggered by a range of factors including but not limited to assessment findings (such as voluntary external evaluation, simulation exercises, after action reviews, risk assessments, It is the prerogative of the countries to choose when to start, which steps to take, and what optional components and tools to use in each step to fit the country context. Countries may choose to initiate a new planning process or update existing non-government, and private sectors, as well as academia, and the international community. etc.); the IHR annual reporting; routine monitoring and evaluation frameworks; national planning and budget cycle reviews; priorities and policies of the government; and the occurrence of large events. The NAPHS process should be integrated with sectoral planning and budget cycles and must consider existing planning cycle timeframes when establishing the duration of the plans. The NAPHS will be reviewed (such asannually) and updated regularly (such as annually) or as needed (following health emergencies). plans based on the local context. The described components of the steps provide guidance on inputs and outputs and are not intended to be sequential. INCEPTION IMPLEMENTATION • Review of existing capacity assessments • Stakeholders analysis • SWOT analysis • Prioritization of areas of action • Reprioritization for implementation • Integrating into national development planning • Monitoring, evaluation and reporting • Periodic review and update DEVELOPMENT • Identification and prioriti- zation of activities (matrix) • Monitoring and evaluation • Costing & mapping resources • Approval and endorsement Situation analysis of country context Multisectoral steering group Draft NAPHS Resource map Plan implemented M&E and reporting NAPHS FRAMEWORK Step 1 – Inception consists of a desktop review of all existing national plans and capacity assessments, stakeholder analysis, SWOT analysis and prioritization of technical areas of action (based on various assessments, existing plans and various national, regional and global strategies). A prioritization exercise can consider strategic costing using a rapid costing tool. INTERNATIONAL HEALTH REGULATIONS (2005) 12 - A 3 step strategic framework for NAPHS Outputs of this step may include: • a situation analysis of the country context, and • an agreement of a governance structure to provide strategic direction to the planning process, such as a high-level, multisectoral steering group. Step 2 – Development consists of identification and prioritization of activities within the technical areas based on risk assessment, monitoring and evaluation framework, detailed costing of activities, mapping resources and endorsement of the plan. Outputs of this step may include: • an approved multi-year, costed national action plan for health security, and • a resource map to provide information on available resources and gaps. Step 3 – Implementation consists of reprio- ritization of the plan for operations based on resource mapping, integration into the national health sector plan, monitoring, evaluation, and periodical reporting and updating of the plan. This step includes implementation of the plan and continued mobilization of additional resources. Outputs of this step may include: • a monitoring, evaluation and reporting process, and • implementation of the plan. 8. CRITICAL COMPONENTS OF A COMPLETED NAPHS DOCUMENT Depending on the strategic approach taken by the country, a completed NAPHS document should have three major parts: 1. A narrative summary containing the situation analysis and a summary of strategic and operational parts of the NAPHS including priority technical areas, costing, overview with a communication strategy and an implementation plan with a process to report. 2. A planning matrix containing detailed priority activities with costing, and mapped resources. 3. Annexes containing all national plans and assessments relevant to the IHR, terms of reference of national multisectoral steering, and technical groups, a stakeholder inventory, the communication strategy, and the imple- mentation plan with the monitoring and process. INTERNATIONAL HEALTH REGULATIONS (2005) 13 - A 3 step strategic framework for NAPHS 8. 1 ST EP 1 : I N CE PT IO N CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS R ev ie w o f p la ns an d ca pa ci ty as se ss m en ts Fo rm a t ea m f ro m k ey h ea lth p ro gr am m es ( su ch a s di se as e co nt ro l, em er ge nc y, et c. ), he al th po lic y, pl an ni ng an d fin an ce un its /d ep ar tm en ts /m in is tr ie s to re vi ew a ll av ai la bl e as se ss m en ts re la te d to h ea lth s ec ur ity . • R is k as se ss m en t o r p ro fil e (S TA R ) • A ss es sm en ts ( SP AR , v ol un ta ry e xt er na l e va lu at io n, Si m Ex , A AR , I H R- PV S) • P la ns , s tr at eg ie s (N H SP , N D P, A M R, P IP P, O H P) , • R eg io na l a gr ee m en ts • C om m un ic at io n an d st ra te gi es Te m pl at e fo r s itu at io n an al ys is S ta ke ho ld er an al ys is Id en tif y m an da te s an d ro le s th ro ug h m ap pi ng st ak eh ol de rs (g ov er nm en t, no n- go ve rn m en t an d m ov in g to w ar ds a s tr at eg ic pa rt ne rs hi p fo r i m pl em en ta tio n. • G ov er nm en t a nd n on -g ov er nm en t s tr at eg ie s re la te d to h ea lth s ec ur ity (m in is tr ie s, W H O, U H C, S D G , U N ) • D ev el op m en t a nd h um an ita ria n pr io rit ie s (C CS , C SA , U N D AF ) St ak eh ol de r a na ly si s te m pl at e S W O T an al ys is Id en tif y ch al le ng es a nd o pp or tu ni tie s fo r pl an ni ng a nd i m pl e- m en ta tio n. • D es k re vi ew a nd s ta ke ho ld er a na ly se s • S um m ar y of s ec to ra l s tr at eg ie s an d pl an s SW O T an al ys is to ol P ri or iti za tio n of te ch ni ca l a re as M ap t he h ea lth s ec ur ity e le m en ts f ro m d es k re vi ew , de te rm in e w he th er a dd iti on al te ch ni ca l a re as fo r a ct io n ar e ne ed ed , p rio rit iz e th e te ch ni ca l a re as fo r a ct io n an d co ns id er s tr at eg ic c os t e st im at es us in g a ra pi d co st in g to ol . • D es k re vi ew , S W O T an d st ak eh ol de r a na ly se s P rio rit iz at io n gu id e O U TP U TS Si tu at io n an al ys is A s itu at io n an al ys is p ro vi de s ba se lin e in fo rm at io n fo r p la nn in g, in cl ud in g th e co un tr y’ s ris k pr ofi le , c ap ac iti es a nd p rio rit y ga ps in th e pr es en t s ys te m to p re ve nt , p re pa re fo r, de te ct a nd re sp on d to h ea lth ri sk s an d ev en ts . I t d efi ne s st ra te gi c ob je ct iv es , p rio rit y ac tio ns a nd a re as o f w or k w ith a ch ie va bl e go al s. It ta ke s in to a cc ou nt th e co un tr y co nt ex t. M ul tis ec to ra l st ee rin g gr ou p H ig h le ve l, m ul tis ec to ra l s te er in g gr ou p or s im ila r ex is tin g pl at fo rm t o gu id e an d di re ct t he p la nn in g pr oc es s an d en su re t ha t it is e nd or se d an d ap pr ov ed a cr os s al l r el ev an t se ct or s an d ad vo ca te d fo r at t he h ig he st le ve l n ec es sa ry f or in te r- m in is te ria l a nd p ar lia m en ta ry c om m itm en t. It w ill al so g ui de th e im pl em en ta tio n pl an ni ng a nd p ro gr am m e m an ag em en t s tr uc tu re n ee de d to o ve rs ee im pl em en ta tio n as w el l a s th e m on ito rin g an d ev al ua tio n pr oc es s. INTERNATIONAL HEALTH REGULATIONS (2005) 14 - A 3 step strategic framework for NAPHS 8. 2 ST EP 2 : D EV EL O PM EN T CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS P ri or iti za tio n of ac tiv iti es Te ch ni ca l w or ki ng g ro up s de ve lo p an d po pu la te a m at rix o f ac tiv iti es , r es po ns ib le a ge nc ie s, ti m el in es a s w el l a s in di ca to rs an d pr io rit iz e th em a cc or di ng t o re su lts f ro m t he s itu at io n an al ys is . • S itu at io n an al ys is Pl an ni ng a nd c os tin g to ol W H O b en ch m ar k to ol P rio rit iz at io n gu id e M on ito ri ng & ev al ua tio n A cr os s- se ct or al m on ito rin g an d ev al ua tio n fr am ew or k fo r N AP H S im pl em en ta tio n ag re ed u po n by t ec hn ic al w or ki ng gr ou ps s im ul ta ne ou sl y w ith a ct iv ity d ev el op m en t. • E xi st in g na tio na l m on ito rin g an d ev al ua tio n pr oc es s • N at io na l b en ch m ar ks a nd in di ca to rs • I H R, S D G , a nd S en da i i nd ic at or s M on ito rin g an d ev al ua tio n G ui de C os tin g an d m ap pi ng re so ur ce s Ca lc ul at e th e co st o f im m ed ia te a nd l on ge r- te rm p rio rit y ac tio ns u si ng b en ch m ar ks a nd /o r t he c os t o f s pe ci fic a ct iv iti es us in g de ta ile d co st in g to ol . Id en tif y re so ur ce s av ai la bl e fr om bo th do m es tic an d in te rn at io na l so ur ce s an d fil l up po te nt ia l ga ps fo r th e im pl em en ta tio n of N AP H S. A lig n w ith n at io na l s ec to ra l b ud ge ts an d re so ur ce s fo r s us ta in ab ili ty . • G ov er nm en t b ud ge t g ui de lin es • M oH , M oF , N D M C an d ot he r re le va nt m in is tr ie s, CC A, C CS , U N D AF , H RP • S ec to ra l b ud ge ts , s tr at eg ie s an d fu nd in g m ec ha ni sm s C ou nt ry ’s c os tin g pr oc es s Pl an ni ng a nd c os tin g to ol A pp ro va l a nd en do rs em en t A ro bu st N AP H S re qu ire s hi gh le ve l m ul tis ec to ra l e nd or se m en t. M ul tis ec to ra l w or ks ho ps , d is se m in at io n an d co m m un ity le ve l ou tr ea ch a re re co m m en de d. S en io r g ov er nm en t o ffi ci al s sh ou ld ta ke p ar t i n th e re le as e an d la un ch o f t he N AP H S. • R ev is ed N AP H S O U TP U TS Re so ur ce m ap A re so ur ce m ap th at d oc um en ts d om es tic fu nd in g so ur ce s, a nd a ny e xi st in g, e xt er na l f un di ng re so ur ce s, a nd fu nd in g ga ps in th e dr af t N AP H S. En do rs ed N AP H S A n en do rs ed N A P H S th at is c os te d an d pr io rit iz ed ; a s w el l a s al ig ne d to e xi st in g st ra te gi es w ith a d efi ne d m on ito rin g an d ev al ua tio n pr oc es s an d pr og ra m m e m an ag em en t s tr uc tu re th at c an c on tin uo us ly re vi ew a nd u pd at e th e ac tiv iti es a nd p la n. A su m m ar y of th e dr af t i s in cl ud ed in th e na rr at iv e pa rt o f t he N AP H S. INTERNATIONAL HEALTH REGULATIONS (2005) 15 - A 3 step strategic framework for NAPHS 8. 3 ST EP 3 : I M PL EM EN TA TI O N CO M PO N EN TS D ES CR IP TI O N IN PU TS TO O LS R ep ri or iti za tio n fo r im pl em en ta tio n R ep rio rit iz at io n an d se qu en ci ng o f a ct iv iti es b as ed o n al lo ca tio n of a va ila bl e an d po te nt ia l r es ou rc es , a nd o ng oi ng a ct iv iti es . • Fi na l N AP H S • Re so ur ce m ap • Pr io rit y m at rix • Co st in g m at rix P rio rit iz at io n gu id e In te gr at in g in to n at io na l de ve lo pm en t pl an ni ng Th e st ee rin g gr ou p en su re s th at t he N AP H S in te gr at es i nt o ex is tin g se ct or al s tr at eg ie s an d do m es tic b ud ge ta ry p la nn in g an d fin an ci ng , em er ge nc y pl an s an d ot he r in te rn at io na l or re gi on al f ra m ew or ks w ith c on tin uo us r es ou rc e m ob ili za tio n to fil l t he g ap s. • S ec to ra l s tr at eg ie s (N H SP , H RP , E PR P) • N at io na l e m er ge nc y m an ag em en t p la ns • E xt er na l f ra m ew or ks M on ito ri ng , ev al ua tio n an d re po rt in g Th e st ee rin g gr ou p de ve lo ps th e op er at io na l pl an fo r im pl em en ta tio n w ith a gr ee d pr og ra m m e m an ag em en t, in cl ud in g ro le s an d re sp on si bi lit ie s of i m pl em en tin g st ak eh ol de rs . It sp ec ifi es a m on ito rin g an d ev al ua tio n fr am ew or k th at is co m pa tib le w ith e xi st in g na tio na l s ys te m s. • N at io na l m on ito rin g an d ev al ua tio n re po rt s • N AP H S m on ito rin g an d ev al ua tio n re po rt s • A ct iv ity re po rt s • I H R m on ito rin g an d ev al ua tio n re po rt s N AP H S m on ito rin g an d ev al ua tio n gu id e P er io di c re vi ew an d up da te Pe rio di c re vi ew a nd u pd at e is e st ab lis he d w hi ch d es cr ib es ho w m aj or o bj ec tiv es a re u pd at ed a nd d oc um en ts a re co rd o f ch an ge s. • F in al N AP H S O U TP U TS Pl an im pl em en te d Th e N A P H S th at is a pp ro ve d by th e re sp ec tiv e au th or iti es in c ou nt ry a im s at ta rg et s to re ac h in th e ne xt fi ve y ea rs . T hi s N A P H S al so h as b uy -i n of a ll re le va nt s ta ke ho ld er s an d is s ha re d w ith a ll th e re le va nt s ta ke ho ld er s. Th is id en tifi es e nt ry p oi nt s in to th e na tio na l b ud ge t c yc le th ro ug h se ct or al d ev el op m en t p la ns . M on ito rin g, ev al ua tio n an d re po rt in g A n im pl em en ta tio n pl an t ha t id en tifi es e vi de nc e- ba se d pr io rit y ac tiv iti es f or i m m ed ia te i m pl em en ta tio n an d ai m s to a ch ie ve q ui ck r es ul ts i s op er at io na liz ed . T hi s ca n be s up po rt ed b y al l a va ila bl e fu nd in g so ur ce s th ro ug h ex is tin g pl an s in c ou nt rie s, s uc h as h um an ita ria n re sp on se , r ec ov er y, em er ge nc y pr ep ar ed ne ss , i n co un tr ie s. Su m m ar y of th e im pl em en ta tio n pl an to b e in cl ud ed in th e na rr at iv e pa rt o f t he N AP H S. T he N AP H S is im pl em en te d an d m on ito rin g an d ev al ua tio n an d re po rt in g is in iti at ed . AA R= A fte r A ct io n Re vi ew ; CC S= C ou nt ry C oo pe ra tio n St ra te gy ; CC A= C om m on C ou nt ry A ss es sm en t ; E PR P= E m er ge nc y Pr ep ar ed ne ss a nd R es po ns e Pl an ; H RP = ; H SS =H ea lth S ys te m s St re ng th en in g ; I H R- PV S= In te rn at io na l H ea lth Re gu la tio ns – P er fo rm an ce o f V et er in ar y Se rv ic es ; M oF =M in is tr y of F in an ce ; M oH =M in is tr y of H ea lth ; N D M C= N at io na l D is as te r M an ag em en t C en te r ; N D P= N at io na l D is as te r P ro gr am m e ; N H SP = N at io na l H ea lth S ec to r P la n ; O H P= O ne H ea lth P la n; P IP P = P an de m ic In flu en za P re pa re dn es s P la n; S D G =S us ta in ab le D ev el op m en t G oa ls ; S im Ex = Si m ul at io n Ex er ci se s ; S PA R = St at e P ar ty A nn ua l R ep or tin g ; S TA R = W H O to ol fo r s tr at eg ic ri sk a ss es sm en t; U H C =u ni ve rs al he al th c ov er ag e; U N =U ni te d N at io ns ; U N DA F= U ni te d N at io ns D ev el op m en t A ct io n Fr am ew or k. CONTACT COUNTRY CAPACITY MONITORING AND EVALUATION UNIT Country Health Emergency Preparedness and IHR World Health Organization 20 Avenue Appia CH-1211 Geneva Switzerland E-MAIL cme@who.int