20 PUBLIC HEALTH AND SOCIAL MEASURES

Public health and social measures (PHSM) are nonpharmaceutical interventions implemented by individuals, communities, governments and institutions to reduce the risk and scale of epidemic- and pandemic-prone infectious disease transmission. They range from surveillance, contact tracing, mask wearing and physical distancing to social measures, such as restricting mass gatherings and modifying school and business openings and closures. PHSM play an immediate and critical role throughout the different stages of health emergencies and contribute to decreasing the burden on health systems so that essential health services can continue and effective vaccines and therapeutics can be developed and deployed with their effects maximized to protect the health of communities. If PHSM are not implemented with a focus on equity and consideration of risks and benefits, they can have unintended negative consequences on the health and well-being of individuals, societies and economies, such as by increasing loneliness, food insecurity, the risk of domestic violence and reducing household income and productivity.

IMPACT:

PHSM are systematically integrated into health emergency management plans, policies, financing, governance and leadership in all relevant sectors at national, subnational and community levels across the health emergency actions, with consideration for interventions that are evidence- driven, context-specific and sensitive to trade-offs between benefits and unintended negative consequences for individuals and communities.

MONITORING AND EVALUATION:

(1) Establishment of a functional, multisectoral and multilevel (i.e. from the national government to the community level) structure for coordination and integration of PHSM in existing governance and leadership mechanisms. (2) Context-specific, evidence-driven decisions on introducing, adjusting and lifting PHSM, including systematic considerations to trade-offs between health benefits and unintended negative consequences.
(3) Establishment of a vertical governance mechanism to ensure sufficient communication and coordination between levels of government
(community, subnational and national) for PHSM.

Benchmark 20.1

Leadership and governance dedicated to PHSM is in place in relevant sectors, at all levels and between levels

Objective To establish and strengthen functional, multisectoral leadership and governance for PHSM that is embedded in health emergency preparedness, response management and health system strengthening

01 NO CAPACITY

  1. No systematic, dedicated mechanism to guide implementation and adjustment of PHSM for emergency management.

02 LIMITED CAPACITY

  1. Review current legislation and legal frameworks relevant to supporting and enabling PHSM implementation and identify any gaps. *
  2. Assess and identify gaps in capacities of health and nonhealth sectors to implement, adjust and monitor PHSM to address priority hazards for health emergencies. *
  3. Involve multilevel multisectoral stakeholders in defining national strategies for PHSM and systematically integrating PHSM in national and subnational emergency management plans/policies. *
  4. Form a national working group with stakeholders from relevant sectors to develop common standards and strategic work plans for health emergency preparedness and response. *
  5. Link continuous risk assessments of epidemiological changes, health system capacity and contextual factors to PHSM policy design, to inform the introduction, adjustment and phasing out of PHSM at national and subnational levels. *
  6. Develop a mechanism to systematically include the evaluation of PHSM in health emergency AARs/IARs. *

03 DEVELOPED CAPACITY

  1. Establish a dedicated PHSM team in the health ministry to coordinate and manage PHSM strategic and operational activities, including PHSM policy monitoring and advice, coordination, leadership and research. *
  2. Form an interdisciplinary, multilevel expert advisory group at the national level to maximize the use of best available evidence on PHSM and employ precautionary principles when robust context specific data and research are limited to enable and strengthen evidence-informed decision-making for PHSM. *
  3. Initiate multilevel, multisectoral tracking of PHSM policy, implementation and adherence at the beginning of a health emergency and maintain tracking to inform adjustment and phasing out of PHSM as required. *
  4. Regularly assess the benefits versus unintended negative consequences of PHSM during health emergencies and implement relevant social protection policies to reduce negative consequences across health, social and economic factors. *
  5. Train and provide ongoing development opportunities for policy makers and practitioners in health and nonhealth sectors to introduce, implement, adjust and phase out context specific, equitable and balanced PHSM policies. *
  6. Systematically integrate PHSM indicators into existing M&E efforts for health emergency management and health systems core capacities. *
  7. Conduct AARs/IARs for PHSM policy, implementation, adjustment and adherence including experts from relevant sectors, communities and professional associations. *
  8. Secure staff, funds, materials and facilities to mainstream and strengthen PHSM in health emergency management while identifying resources and developing mechanisms to swiftly raise and allocate funds for rapid expansion of country capacity for PHSM during health emergencies. *
  9. Systematic involvement from all relevant stakeholders in PHSM leadership and governance including M&E, reporting and strategic planning.
  10. Regularly share timely information from PHSM focal points in relevant sectors to help inform PHSM actions.

04 DEMONSTRATED CAPACITY

  1. Review and adjust PHSM policies and implementation based on timely and regular assessment of data through close community engagements and communicate effectively and transparently to the public *
  2. Develop a sustainable financial and human resource plan at all levels for PHSM coordination *
  3. Routinely monitor PHSM and related population response and uptake in a harmonized manner. *
  4. Expand partnerships for a whole-of-society approach for collaborative capacity-building, strategic planning and monitoring of PHSM. *
  5. Develop partnerships with and build core capacities of CSOs and community leaders to increase community engagement, trust and adherence to PHSM. *
  6. Develop a national research agenda for PHSM and provide support to conduct studies to measure the effectiveness, impact and contextual factors related to PHSM *
  7. Utilize a whole-of-society, whole-of-government approach to integrate PHSM in NHPSPs. *
  8. Establish whole-of-government mechanisms with well defined governance and mandates to implement relevant PHSM. *
  9. Establish a coordinating team among PHSM focal points in all relevant sectors and identify a network of experts from relevant disciplines for collaboration and consultation on PHSM.
  10. Integrate policies and strategies to strengthen research capacities in nonhealth sectors and catalyse PHSM research, including studies on the social and economic impacts of PHSM.

05 SUSTAINABLE CAPACITY

  1. Review and adjust existing legislation, regulations, mechanisms and mandates of all relevant sectors based on M&E outcomes for effective implementation of PHSM *
  2. Establish and continuously update a network of multidisciplinary experts trained in precautionary principles, risk-based approaches, evidence synthesis and knowledge translation for multihazard PHSM decisions before emergencies and activation during health emergencies. *
  3. Disseminate good practices, lessons learned and outcomes of PHSM among experts, decision-makers, community, etc. in consideration of contextual factors. *
  4. Document and share lessons learned and experiences in implementing and improving PHSM by engaging the country in peer-to-peer learning programmes at the subnational, national and international levels. *
  5. Provide strategic and technical support to other countries as requested including through bilateral and regional arrangements *
  6. Establish plans for whole-of-society approaches to fully engage communities in PHSM decisions and implementation.
  7. Collaboration across all relevant sectors to develop legislation and policies that offer adequate social protection for individuals and communities, especially those in vulnerable conditions, to mitigate social and economic consequences of PHSM.

* Participation and contribution of other sectors to action.

Tools