01 LEGAL INSTRUMENTS

LEGAL INSTRUMENTS: Adequate legal instruments for States Parties to support and enable the implementation of all their obligations and rights created by the International Health Regulations (2005) (IHR). The development of new or modified legal instruments in some States Parties for the implementation of the Regulations. Where new or revised legal instruments may not be specifically required under a State Party’s legal system, the State may revise some laws, regulations or other legal instruments in order to facilitate their implementation in a more efficient, effective or beneficial manner.

IMPACT:

Legal instruments are in place in all relevant sectors to support IHR implementation including core capacity development and maintenance.

MONITORING AND EVALUATION:

Current legal instruments including constitutions, laws, arrêtés, decrees, regulations, administrative requirements or other government instruments are proven to adequately support IHR implementation across relevant sectors.

GENDER: All persons irrespective of their gender identity (men, women and gender diverse people), should have equal and equitable access to service delivery during health emergencies, support and protection to effectively conduct their work as part of the workforce responding to health emergencies, and protection from marginalization and stigmatization during health emergencies, among others. This needs to be supported by adequate systems that incorporate a gender- responsive approach, including through the identification of relevant data that can inform gender-specific vulnerabilities, risks and coping capacities. This data can in turn inform the design of appropriate strategies to increase resilience throughout health emergency preparedness, response and recovery cycles. The integration of gender analysis within systematic assessments conducted across relevant sectors can help identify key opportunities and challenges that strengthen health emergency preparedness, response, recovery and IHR implementation. The identified priority gender gaps should be addressed with sustainable strategies and integrated through multisectoral action across all IHR capacities.

IMPACT:

Gender informs the design of health emergency preparedness, response and recovery legal instruments, frameworks and strategies, resulting in equal and equitable access to health services, information and protection mechanisms for health security. Moreover, the integration of gender- responsive approaches into health emergency preparedness, response and recovery will help achieve gender parity and gender equality in the workplace, balance representation in leadership and decision-making roles (particularly increasing representation of women), and help ensure decent working conditions for all.

MONITORING AND EVALUATION:

Gender equity and equality is integrated in relevant sectors involved in IHR implementation and in response to all health threats and emergencies.

Benchmark 1.1

Legal instruments are in place across relevant sectors to support and enable IHR implementation and compliance

Objective To document and review legal instruments to identify gaps across relevant sectors and develop new or revise legal instruments as necessary to support and facilitate IHR implementation and compliance in a more efficient, effective or beneficial manner 

01 NO CAPACITY

  1. The country has not conducted legal mapping (identification, review, collection and documentation of relevant legal instruments) for IHR implementation.

02 LIMITED CAPACITY

  1. Establish a national multisectoral coordination working group (with drafted terms of reference (ToRs)) for legal preparedness to convene key stakeholders to coordinate the identification, review, collection and documentation of legal instruments for IHR implementation across relevant sectors. *
  2. Identify experts from relevant sectors (outside of public health) who should be part of the national multisectoral coordination working group for aligning efforts to review identified gaps for IHR implementation in the health sector. *
  3. Identify human resource capacity to complete the legal mapping process, including development of mechanisms to enhance legal literacy across relevant sectors on strengthening legal preparedness. *
  4. Identify, review and collect available legal instruments across sectors relevant to health emergency prevention, preparedness and response that enable effective implementation and compliance with IHR requirements. *
  5. Develop an implementation plan and timeline for conducting legal mapping and legal analysis at the national and subnational levels, where applicable. *
  6. Conduct legal mapping of identified legal instruments for IHR implementation at national and subnational levels. *
  7. Develop advocacy materials and packages to raise awareness on the process and resources needed to conduct a legal mapping and legal analysis at the national and subnational levels, where applicable. *
  8. Identify legislative/policy champion(s) who can advocate for the role and necessity of conducting legal mapping and legal analysis at the national and subnational levels. *

03 DEVELOPED CAPACITY

  1. Establish a unit or function within the health sector to serve as a liaison across relevant sectors, ensure legal mapping documentation is kept up to date and to align activities across relevant sectors. *
  2. Conduct legal analysis (legal mapping and legal assessment) and develop or revise the necessary legal instruments for IHR implementation at the national and subnational levels. *
  3. Complete a functional review using legal mapping results to identify, understand, assess and analyse gaps within the country's legal instruments for IHR implementation across the health sector at the national and subnational levels, where applicable. *
  4. Complete a multisectoral review of identified gaps for IHR implementation across the health sector and develop or revise legal instruments in the health sector at the national and subnational levels, where applicable. *
  5. Use and update strategies and materials (e.g. communication strategies with targeted messaging based on stakeholder) to advocate for needed changes to legal instruments to support enhanced IHR compliance in the health sector at the national and intermediate levels, where applicable. *
  6. Increase awareness of changes required to ensure that legal instruments support enhanced IHR compliance through legislative/policy champions. *
  7. Develop training curricula for health and relevant sector experts about legal instruments for health emergency prevention, preparedness and response. *
  8. Involve all national legislative and regulatory bodies, as well as law enforcement bodies (e.g. parliament, senate, interministerial committees, police, national security agencies, etc.) in regular preparatory meetings about proposals for revision of IHR related legal instruments.
  9. Involve relevant professional organizations (e.g. medical associations, law associations) and civil society organizations (CSOs) in discussions around revising legal instruments.

04 DEMONSTRATED CAPACITY

  1. Conduct a legal analysis across relevant sectors and government levels (to complement the health sector's legal analysis) to identify, understand, assess and analyse gaps within the country's legal instruments for IHR implementation. *
  2. Analyse any conflict of law in legal instruments for IHR implementation across relevant sectors. *
  3. Convene a national multisectoral coordination working group for legal preparedness to align efforts to review identified gaps in legal instruments for IHR implementation across sectors and develop or revise legal instruments at the national and subnational levels, where applicable. *
  4. Routinely organize and conduct simulation exercises, after action reviews, intra-action reviews (SimEx/AAR/IAR) (as relevant) to monitor and evaluate the implementation and effectiveness of legal instruments relating to IHR implementation. *
  5. Develop or revise legal instruments as necessary based on identified gaps for IHR implementation across all sectors and all levels of governance. *
  6. Develop and adjust advocacy strategies and materials to support development and revisions of necessary legal instruments across all sectors and all levels of governance. *
  7. Maintain a routine training curricula for health and relevant sector experts about legal instruments for health emergency prevention, preparedness and response at national and subnational levels. *
  8. Monitor and control compliance with relevant legal instruments in relevant sectors and adjust when required.
  9. Identify clear roles and legal responsibilities for IHR implementation across relevant sectors (i.e. human health, animal health, environment, military, education, social protection, etc.).

05 SUSTAINABLE CAPACITY

  1. Provide mechanisms for continuous monitoring and evaluation (M&E) of current legal instruments and tracking changes over time (legal surveillance) for implementation of IHR. *
  2. Amend or revise relevant legal instruments, based on lessons learned from M&E, continuous data collection and SimEx/AAR/IAR. *
  3. Participate in international initiatives to support country and organization effort to build capacity in legal preparedness in line with the IHR. *
  4. Engage the country in peer-to-peer learning programmes at the subnational, national and international levels. *
  5. Maintain and improve the availability and accessibility of the country’s legal instruments (through a publicly available database) in order to promote global information sharing to achieve a common and collective understanding of legal preparedness. *
  6. Assess country governance structure and context to ensure that the country has a governance environment that enables effective IHR implementation with solid and reliable institutions and sound domestic policies that fully respect the dignity, human rights and fundamental freedoms of persons.
  7. Document, widely disseminate and apply relevant existing and updated legal instruments and administrative requirements appropriately by relevant sectors.

Benchmark 1.2

Gender equity and equality principles are applied throughout IHR capacities

Objective To integrate gender equity and equality within all IHR capacity areas to ensure gender-based health inequities and inequalities are not exacerbated by health emergency prevention, preparedness, response or recovery interventions

01 NO CAPACITY

  1. No analysis available on health-related gender inequities and inequalities in the context of health emergencies, to inform health emergency prevention and preparedness strategies.
  2. No efforts made to specifically promote gender equity and equality and respect for human rights commitments advance health equity within any IHR capacities.
  3. No coordination mechanisms exist to oversee the gender responsiveness of health emergency preparedness and response interventions.
  4. There is a dearth of gender-responsive interventions within operational plans for the strengthening of IHR core capacities or the operationalization of health emergency preparedness and response plans.

02 LIMITED CAPACITY

  1. Integrate gender analysis into specific IHR capacity assessments in relevant sectors to identify and prioritize gender gaps, and integrate indicators to measure effects of gender norms, roles and relations on an individual’s differential vulnerability to health emergencies, including treatment received, immediate and long-term effects, and differences between persons with different gender identities. *
  2. Compile key sources of information (e.g. academic-, scientific-, government-led or other) to identify key sociocultural, economic and other factors influencing gender gaps in access to and use of health information, services, care and treatment for essential health services in the country. *
  3. Promote collection, analysis, dissemination and use of data disaggregated by sex and age at minimum, and by pregnancy status, across all IHR capacities. *
  4. Identify government entities tasked with overseeing, developing and implementing gender equity and equality policies, and engage to establish formal or informal coordination mechanisms for application of these policies within the health sector, with special reference in health emergencies (e.g. the ministry/secretary of women’s affairs, child protection authorities, social welfare and sociology departments, or others). *
  5. Appoint an official focal point responsible for cross-sectoral engagement for gender equity and equality and health emergencies and identify gender focal points in relevant sectors such as education, social welfare and employment. *
  6. Conduct a stakeholder analysis to identify relevant actors that could support integration of gender-responsive actions across IHR capacity areas, and identify linkages between programmes dedicated to the advancement of gender equity and equality (including education, social and economic sectors) and the development of IHR core capacities. *
  7. Develop training curricula to raise awareness and understanding of gender and human rights issues within health security. *
  8. Assess whether decision making mechanisms for IHR core capacities incorporate equitable representation of diverse stakeholders, including balanced gender representation. *
  9. Establish a robust national communications strategy to promote gender-specific needs and considerations during health emergencies. *
  10. Institutionalize national policy frameworks promoting the advancement of non-discrimination and gender equity and equality.

03 DEVELOPED CAPACITY

  1. Conduct novel research jointly with relevant stakeholders (including government and nongovernment actors) to assess gender-based health inequities and inequalities; how these may be exacerbated by potential health emergencies and how they negatively affect the country’s (and individuals’) capacity to prepare, respond and recover from health emergencies. This could also include holding consultations with communities living in vulnerable situations to identify priority gender needs and potential implementation mechanisms, to inform development of IHR sector specific action plans. *
  2. Identify and prioritize gender gaps in both service delivery and service access based on gender analysis data collected through IHR capacity assessments, compilation of key sources of information and novel research, to be addressed with short-, medium- and long-term interventions. *
  3. Develop and implement an advocacy package based on gender gap analysis to support integration of gender-responsive actions into relevant IHR legislation and sector-specific action plans, with dissemination to relevant decision-makers and policymakers. *
  4. Promote intersectional analysis of sex and age disaggregated data, including income, place of living, language, ethnicity, gender diverse people and other variables to identify most vulnerable communities. *
  5. Coordinate with relevant government sectors working on human rights-based approaches and gender equality skills to conduct trainings and seminars to raise awareness and build an intersectoral team of experts with skills to integrate gender within IHR core capacity development. *
  6. Identify a unit or team with established ToRs to be the focal point from the health ministry to oversee progress towards integration of gender-responsive approaches into health service access and delivery. *
  7. Jointly work with relevant sectors to integrate gender analysis findings into planning and development of IHR capacities and corresponding actions. *
  8. Develop a standalone, multisectoral gender equality strategy for health emergency preparedness, response and recovery, linked to IHR capacities and to broader national gender policies and frameworks. *
  9. Integrate gender-responsive approaches, informed by a gender analysis, into national policies to ensure equal and equitable access to services, including for all genders, in education, health, employment and living conditions.
  10. Integrate health security into the national gender policy objectives to ensure gender dimensions of health emergency preparedness, response and recovery are addressed.
  11. Integrate health emergency scenarios into capacity building efforts led by relevant sectors such as the ministry of social/family/women’s affairs, to raise awareness of the continued relevance of gender in the context of health emergencies.

04 DEMONSTRATED CAPACITY

  1. Systematically conduct gender analysis of health information systems data, on health seeking behaviour, service access, service provision and other data related to health emergency response and recovery in relevant surveillance systems. *
  2. Promote discussions, public engagements and seminars on gender equity and equality in health emergencies as an essential thematic area and disseminate findings of systematic data collection systems to ensure continuous engagement and positioning of the relevance of gender equity and equality for IHR. *
  3. Establish a functional multisectoral coordination mechanism of gender focal points and experts tasked with periodically reviewing progress on the integration of gender into IHR capacity development, identifying gaps and issuing recommendations to inform future planning. *
  4. Appoint a gender advisor within health sector M&E teams responsible for monitoring data collected for gender-responsive interventions and initiatives and reporting on IHR, including integration of gender equity and equality principles in health emergencies as a pillar to assess in SimEx/AAR/IAR (as relevant). *
  5. Identify and implement evidence-based, sector-specific interventions for the integration of gender-responsive approaches for health security. *
  6. Integrate specific objectives related to gender inequities and inequalities in health into national health sector policies and strategies, including in health emergency contexts, with budgeted activities and a monitoring framework that reflects gender-responsive indicators. *
  7. Integrate training modules focused on gender analysis in health and gender-responsive programming skills into national health systems trainings. *
  8. Include gender equity and equality with special reference to health emergency prevention, preparedness and response as a major thematic area in multisectoral research symposia, orations, conferences and other academic and/or scientific venues that focus on health systems. *
  9. Incorporate gender analysis and interventions for gender equity and equality into curricula and research agendas for undergraduate and postgraduate research in relevant subject streams (e.g. sociology, disaster management, public health, epidemiology, etc.). *

05 SUSTAINABLE CAPACITY

  1. Collect, analyse and use on a periodic basis, indicators, statistical approaches and monitoring tools (including qualitative and mixed methods approaches) to understand and address gender inequality in health emergencies, including at subnational levels. *
  2. Identify and integrate M&E indicators to track progress towards gender-responsive health security within relevant strategies, including through the establishment and maintenance of data platforms to identify gender gaps in health service access and delivery during health emergencies. *
  3. Document best practices and lessons learned related to addressing gender inequalities in health emergencies and disseminate widely across IHR capacities, relevant sectors and external partners to encourage peer-to-peer learning and knowledge-sharing across countries. *
  4. Develop and sustain mechanisms to monitor, detect and address unequal gender distribution in key decision-making roles across the health system. *
  5. Outline specific objectives within the national IHR capacity development strategies that seek to increase the ratio of reached populations in vulnerable situations – disaggregated by sex and age – during preparedness, response and recovery interventions. *
  6. Establish clear funding streams to support gender integration across IHR capacity areas and ensure that specialized gender functions and specialists are in place and adequately resourced. *
  7. Establish an accountability framework that is aligned with the national gender policy, against which staff, systems, structures and activities are audited. *
  8. Focus all relevant national policies on addressing gender inequity and inequality, and make reference to interlinkages with health emergencies and the implementation of IHR capacities.
  9. Develop mechanisms to monitor, evaluate and report gender inequities and inequalities across relevant sectors.
  10. Develop an action plan to operationalize the national gender policy, including health security objectives.

* Participation and contribution of other sectors to action.

Tools