Evaluating Implementation of International Health Regulations Core Capacities: Using the Electronic States Parties Self-Assessment Annual Reporting Tool (E-Spar) to Monitor Progress with Joint External Evaluation Indicators.

The International Health Regulations (IHR) are a legally binding instrument designed to improve Global Health Security by limiting the cross boarder spread of health risks. All 196 signatories to the IHR (2005) are required to report progress towards IHR core capacity implementation through an annual multi-sectoral self-assessment process known as the State Parties Self-Assessment Annual Reporting (SPAR). This mandatory process sits alongside the voluntary, external, peer-reviewed Joint External Evaluations (JEE) as two core components of the IHR monitoring and evaluation framework. JEEs are intended to occur once every 4–5 years following a voluntary request from the member state. This means that interim monitoring of IHR core capacity compliance, can be challenging and additional data sources are required. The outputs of the SPAR process represent one such source. Although the JEE and SPAR tools are intended to be complimentary, there has been no publicly available mapping of JEE indicators to SPAR indicators in order to inform progress on IHR compliance. This paper mapped JEE indicators to SPAR indicators and found a high level of correlation suggesting the SPAR process offers a method for countries and technical assistance programmes to monitor progress on IHR compliance and identify gaps in between JEE visits. However, coverage was not complete, and several gaps were identified most notably in antimicrobial resistance (AMR) and vaccinations. Enhancing alignment between JEE and SPAR could offer a more consistent and complete way of assessing compliance with IHR.