Developing a comprehensive framework for evaluating public health emergency management program implementation: A scoping review.

Background: Uncertainty is inherent in public health emergency management (PHEM) due to the unpredictable nature of emergencies and interplay of public health threats and their drivers. PHEM practitioners must continually develop and adapt methods to manage this uncertainty. General morphological analysis (GMA) is a computer-aided scenario modelling method that effectively addresses issues where uncertainty exists. GMA examines possible components of a complex problem and allows practitioners to consider potential connections and outcomes. Through iterative steps, GMA can generate new knowledge and insights in the development of scenarios to aid in decision-making and planning within PHEM. Method: An environmental scan was designed to identify articles that utilized GMA as one of the primary methodologies across different natural hazards within the context of PHEM. Academic databases included PubMed and Research Gate. A broad search strategy was applied to scan grey literature which included Google Scholar. Results: This environmental scan identified ten examples of GMA employed in PHEM across multiple countries and organizations. Examples in the literature targeted either a specific natural hazard or broadly targeted all known natural hazards. The findings can be divided into three interconnected categories: (a) scenario modelling for managing natural disasters, (b) strategy development and prioritization tools, and (c) decision-making support tools for emergency management teams. Conclusions: GMA is a decision-making and planning tool in PHEM that can be extended beyond scenario modelling to address uncertainties. This modelling method leverages subject matter experts to uncover innovative connections and outcomes when navigating complex problems like those observed within PHEM. Future research can involve applying GMA to PHEM in a Canadian context. Currently, the Public Health Agency of Canada is applying GMA to cyclical events (e.g., wildfires, floods, extreme heat events, and extreme weather events) to create scenarios using a PHEM lens. Future practice should involve integrating GMA with other PHEM methodologies to enhance strategies to prevent, prepare, respond and recover from future public health emergencies.

Humanitarian crises and infectious diseases remain major global and national public health concerns, emphasizing the need for strong public health emergency management systems. Ethiopia established its Public Health Emergency Operations Centre (PHEOC) in 2017 to improve preparedness and response. Assessing the PHEOC’s experience is important for generating practical insights and lessons learned, yet limited evidence exists in this area. In this perspective, we discuss the experience of PHEOC implementation in terms of its core components from August 2017 to December 2023 and identify areas that need strengthening and lessons learned for effective public health emergency response in Ethiopia. We conducted comprehensive desk reviews at the Ethiopia Ministry of Health, Ethiopian Public Health Institute (EPHI), Regional Public Health Institutes, and Health Bureaux using the READ (Ready materials, Extract data, Analyse data, Distil) approach. The major findings were synthesized and described thematically. Between August 2017 and December 2023, the PHEOC handbook and Standard Operating Procedures (SOPs), training curriculum and manuals, multi-hazard emergency preparedness and response plans, and several hazard-specific response plans developed; all core staff and more than 348 national and subnational experts in PHEOC and IMS; and 190 African Health Volunteers Corps (AVoHC) SURGE folks trained in public health emergency management principles; participatedin more than 10 simulation exercises; established 14 regional and 8 subregional PHEOCs; and strengthening the capacity of neighbouring countries such as South Sudan and Somalia in public health emergency management and coordinated responses to 11 major PHEs. These underscores how a strengthened PHEOC system contributes to enhanced regional and cross-border health security and resilience against public health threats. Hence, the need to further enhance PHEOC, empowered by adequately implementing legal instruments; improving infrastructure; and conducting subsequent simulation exercises to test staff capability and PHEOC procedures, as well as plans for regional and subregional PHEOCs, is recommended.

This study systematically evaluated tools, frameworks, and methodologies to inform the development of a comprehensive and scalable human resource development (HRD) roadmap for sustainable public health emergency management (PHEM) in low-income and middle-income countries (LMICs), with a specific focus on Ethiopia. A scoping review was conducted following established methodological frameworks, drawing evidence from PubMed, Web of Science, and Scopus, complemented by grey literature from Google Scholar and institutional websites such as the Africa Centres for Disease Control and Prevention and the Ethiopian Public Health Institute. Studies published between 2000 and 2025 addressing HRD strategies for PHEM in LMICs, including case studies, reviews, frameworks, and policy documents relevant to Ethiopia, were eligible for inclusion. Data were extracted using a structured template capturing study characteristics, methods, and recommendations, and thematically synthesized into HRD domains. Forty-three studies met the inclusion criteria, yielding nine cross-cutting themes: public health competencies, emergency preparedness, workforce retention, training and capacity building, community engagement, decision-making frameworks, technology integration, governance and policy, and global best practices. Evidence highlighted the importance of competency-based frameworks, interagency coordination, innovative training, and equity-focused approaches. Ethiopian findings revealed progress in competency development and field training but persistent gaps in institutionalisation, financing, and sustainability. The review underscores the urgent need for a standardised HRD roadmap that integrates adaptable strategies, community engagement, gender equity, and governance reforms to enhance workforce preparedness and resilience in future health emergencies.

Learning from public health emergencies has not always been possible due to suboptimal knowledge accrual from previous outbreaks. This study described the knowledge attributes of Health Management Information Systems (HMIS) that are currently used during health emergencies. It aims to inform the development of a "nuggets of knowledge" (NoK) platform to support agile decision-making and knowledge continuity following health emergencies. A search was conducted on the Web of Science and Google Scholar, with no date restriction for articles that conveniently selected 13 HMIS and their knowledge attributes. Proportions were used to summarize HMIS distribution by countries' World Bank income status. Thematic content analysis was used to describe knowledge attributes of HMIS based on the knowledge attributes of Holsapple et al. Seven of the 13 HMIS contained tacit knowledge; the 7 HMIS were predominantly used in higher-income settings and developed after explicit knowledge containing HMIS. More HMISs that contained tacit knowledge were currently usable, universal, programmable, user-friendly, and relied on informal information sources than HMIS that contained explicit knowledge HMIS. Tacit and explicit knowledge containing HMIS were equally practical, accessible, and domain-oriented. HMIS should continuously capture both tacit and explicit knowledge that is actionable and practical in HMIS, user-friendly, programmable, and accessible to persons in all geographical settings. HMIS that contain tacit knowledge have more favorable attributes than those that contain explicit knowledge, but they may not be available to all emergency responders globally, a distribution that may change as newer low-cost technologies become available. Future research should investigate the impact of the NoK platform on public health emergency management.

The public health system has a specialized body of knowledge and expertise in bioterrorism and public health emergency management that can assist in the development and delivery of continuing medical education programs to meet the needs of emergency medical service providers. A nationally representative sample of the basic and paramedic emergency medical service providers in the United States was surveyed to assess whether they had received training in weapons of mass destruction, bioterrorism, chemical terrorism, radiological terrorism, and/or public health emergencies, and how the training was provided. Local health departments provided little in the way of training in biologic, chemical, or radiological terrorism to responders (7.4%-14.9%). State health departments provided even less training (6.3%-17.3%) on all topics to emergency medical services providers. Training that was provided by the health department in bioterrorism and public health emergency response was associated with responder comfort in responding to a bioterrorism event (OR = 2.74, 95% CI = 2.68, 2.81). Local and state public health agencies should work with the emergency medical services systems to develop and deliver training with an all-hazards approach to disasters and other public health emergencies.

Against the background of the worldwide spread of the COVID-19 pandemic, due to the lack of effective collaborative incentive mechanisms, issues of dislocation and incoordination have emerged in the public health emergency management system (PES) globally. Nevertheless, the available research rarely touches upon the incentive mechanism design for the collaborative management of PES. To alleviate these inefficiency operations problems with PES, three game-theoretical decision models, including a decentralized decision model without public governance policy incentive (GPI), a decentralized decision model with GPI, and a collaborative decision model with GPI, were developed and analyzed to explore and design the incentive mechanism of PES. Furthermore, the corresponding numerical and sensitivity analyses were conducted to validate the modelling results in the article. The research results show that: (1) the collaborative decision scenario with GPI performs best, and the decentralized decision scenario with GPI performs second-best regarding the equilibrium emergency management efforts (EMEs) and utilities in all the decision scenarios; (2) an incentive mechanism of the “carrot + Stick” can effectively enhance the collaborative management of public health emergencies and its governance-driven operational performance/efficiency; (3) strengthening the performance assessment of emergency management for relevant government departments is beneficial in improving the overall emergency management efficiency of the PES; (4) reducing the cost of EMEs and enhancing the effectiveness of EMEs are conducive to improving the overall emergency management efficiency of the PES. This research provides a novel framework for designing an effective incentive mechanism to overcome the incoordination impacts and achieve collaborative operations across the PES.

To gather information that would assist China's central government and local governments in public health emergency management, we conducted focus groups to identify current problems. In three provinces, selected to reflect differing economic and social status, we met with two groups each, composed of public health officials and practitioners. Sampling to achieve a mix and for convenience, we followed a guide to cover five topics. Eleven common problems emerged. China's central government and local governments should take immediate action to solve these remaining problems in public health emergency management.

At present, major public health emergencies frequently occur worldwide, and it is of great significance to analyze the research status and latest developments in this field to improve the ability of public health emergency management in various countries. This paper took 5,143 related studies from 2007 to 2020 from the Web of Science as research object and used CiteSpace, VOSviewer, and other software to perform co-word analysis, social network analysis, and cluster analysis. The results and conclusions were as follows: (1) the related research identified three periods: the exploration, growth, and outbreak period; (2) chronologically: the relevant research evolved from medical and health care for major diseases to emergency management and risk assessment of public health emergencies and then researched the novel coronavirus (COVID-19) pneumonia epidemic; (3) clustering analysis of high-frequency keywords, identifying three research hotspots: “disaster prevention and emergency medical services,” “outbreak and management of infectious diseases in Africa,” and “emergency management under the COVID-19 pneumonia epidemic.” Finally, this study combined the data and literature analysis to point out possible future research directions: from the research of the COVID-19 pneumonia epidemic to the research of general major public health emergencies, thinking and remodeling of the national public health emergency management system, and exploring the establishment of an efficient international emergency management cooperation mechanism.

Background and AimIn the long-term prevention of the COVID-19 pandemic, parameters may change frequently for various reasons, such as the emergence of mutant strains and changes in government policies. These changes will affect the efficiency of the current emergency logistics network. Public health emergencies have typical unstructured characteristics such as blurred transmission boundaries and dynamic time-varying scenarios, thus requiring continuous adjustment of emergency logistics network to adapt to the actual situation and make a better rescue.Practical SignificanceThe infectivity of public health emergencies has shown a tendency that it first increased and then decreased in the initial decision-making cycle, and finally reached the lowest point in a certain decision-making cycle. This suggests that the number of patients will peak at some point in the cycle, after which the public health emergency will then be brought under control and be resolved. Therefore, in the design of emergency logistics network, the infectious ability of public health emergencies should be fully considered (ie, the prediction of the number of susceptible population should be based on the real-time change of the infectious ability of public health emergencies), so as to make the emergency logistics network more reasonable.MethodsIn this paper, we build a data-driven dynamic adjustment and optimization model for the decision-making framework with an innovative emergency logistics network in this paper. The proposed model divides the response time to emergency into several consecutive decision-making cycles, and each of them contains four repetitive steps: (1) analysis of public health emergency transmission; (2) design of emergency logistics network; (3) data collection and processing; (4) adjustment and update of parameters.ResultsThe result of the experiment shows that dynamic adjustment and update of parameters help to improve the accuracy of describing the evolution of public health emergency transmission. The model successively transforms the public health emergency response into the co-evolution of data learning and optimal allocation of resources.ConclusionBased on the above results, it is concluded that the model we designed in this paper can provide multiple real-time and effective suggestions for policy adjustment in public health emergency management. When responding to other emergencies, our model can offer helpful decision-making references.

The development of ideological and political education in the new era should constantly carry out self-innovation under the condition of adapting to the new situation and new requirements. Up to now, the phased results of the previous response to the new crown pneumonia epidemic have demonstrated China's institutional advantages and governance effectiveness. But at the same time, it also found that ideological and political education in the public health emergency management gap, this is the social environment and reality needs to give ideological and political education to the new era requirements, under the clear requirements, follow the psychological development law and crisis change law of people in the crisis period, explore the integration and development of ideological and political education and public health emergency management, is the key to the new era of ideological and political education to adapt to social development, but also the embodiment of the innovative development of public health emergency management.

The construction of medical infrastructure is a significant part of urban modernization. The accessibility of medical resources reflects the ability to respond and decentralize control in emergency management of public health emergencies. An improved gravity model is used to evaluate the accessibility of urban medical services based on the hospital and population distribution in a typical metropolis, and conducts a spatial analysis of control areas of urban public health emergency management, so as to identify risk points and propose improvements.

Background Influenza pandemic preparedness plans should be adopted, regularly updated in every country, and comply with international guidelines to ensure proper management of public health emergencies. In Italy, each region develops its pandemic plan based on a National Plan. This study, conducted within a project funded by the Italian Ministry of Health, aims to assess the level of compliance of these plans with the national guidelines. Methods The assessment was based on a checklist of 192 items reporting the actions prescribed by the national plan. The items were divided into macro-areas by pandemic phase: general, alert, inter-pandemic, pandemic, and transition. The compliance regarding the presence and contextualization of each item in the regional plans was evaluated. Each macro-area was further assessed for easy identification of actions, congruence with the National Plan, and contextualization in the regional healthcare system. Some analyses grouped the regions into North, Centre, and South/Islands. Results Some macro-areas, such as ‘Communication’ and ‘Prevention and Control measures,’ showed some weaknesses in all phases, especially in the northern regions, which reached levels of full compliance below 50%. Central regions were highly compliant in almost all macro-areas, especially in ‘Strategy/Governance’ (100%), ‘Supplying’ (75-100%), and ‘Surveillance’ (75-100%). Overall, contextualization was the weakest aspect in all phases, while easy identification and congruence were mainly better achieved. Only three regions fully met all the assessed parameters. Conclusions A strict surveillance and monitoring process of planned activities is necessary to strengthen the country’s preparedness. This study identified critical issues and key areas for improvement at the regional level. This might allow us to verify the correct implementation of national guidelines and define the best strategies for improving readiness for public health emergencies in the future. Key messages • Implementation of the Italian influenza pandemic plan was uneven across regions. • Identification of lacking areas of the regional implementation is essential to improving national preparedness.

Using the COVID-19 pandemic to frame the discussion, this paper explores the potential ethical impacts of a greater reliance on robots during a public health emergency. Through an examination of various uses of different kinds of robots across the prevention, response, and recovery phases of the pandemic, this paper considers ethical pitfalls as well as the possible benefits of expanded deployment and use of robots to facilitate human management of public health emergencies. Alongside consideration of pandemic-related uses of robots, this paper also explores ethical concerns related to their use in public health practice and health care beyond the context of a public health emergency.

To evaluate Brazil's public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). In 2008-2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). Overall, at all three levels of government, Brazil's HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. In general, the core capacities of Brazil's HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels.

Systematic evaluation of emergency management capacity for rural public health emergencies