Assessment of National Multisectoral Pandemic Preparedness and Response

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Assessment of National Multisectoral Pandemic
Preparedness and Response

• Pilot Assessment
• Indonesia
• June 2009

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AGENDA FOR THIS PRESENTATION

• Scope, purpose and objectives of the Pilot
  Assessment
• Indonesia Country Report Findings
• Review of the Pilot Assessment Design and Process
  Issues Arising

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Scope of the Assessment A multisectoral program
and assessment framework

• Pandemic Preparedness and Response (PPR) at WHO
  Pandemic Alert Phases 4-6 centered on continuity
  of essential services

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Scope of assessment Not an animal and human
health program and assessment framework

• Pandemic Preparedness and Response (PPR) at WHO
  Pandemic Alert Phases 1-3 centered on animal and
  human health

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Pilot assessment purpose and objectives

• Conduct a situation analysis (not intended as an
  audit).
• Identify gaps and take corrective actions.
• Identify or verify areas that can be
  assisted/supported by partners.
• Pilot test an assessment approach and
  methodology, and learn what works and what
  doesnt work

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How the Indonesia Pilot assessment and findings
were organized

• National Government Planning and Coordination
• Sub-national Government Planning and Coordination
• Whole of Society Planning and Implementation
• Sector Planning and Continuity of Essential
  Services

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Indonesia Country Report Findings

• National Government Planning and Coordination
• Komnas FBPI is well positioned, has increasingly
  taken on many of the features of a central
  government multisectoral coordinating body for
  pandemics and is moving in the right direction,
  but Komnas has not yet achieved the full
  transition.
• Komnas FBPI actively supports Phase 6 PPR
  activities, and may have other opportunities to
  provide timely information and support to
  sectors, organizations and agencies in such areas
  as contingency and Business Continuity Planning.
• Indonesia does not yet have a national
  multisectoral coordinating committee for pandemic
  preparedness and response decreed by the central
  government as envisioned in the ASEAN indicators.

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Indonesia Country Report Findings

• Sub-national Government Planning and Coordination
• In the one province and district visited, local
  government officials expressed little-to-no
  knowledge about what activities are underway in
  the area of pandemic preparedness planning and
  coordination in their areas of jurisdiction.
• In contrast, the municipal/sub-district visited
  reported an impressive range of village level
  planning, training, socialization, and exercises,
  and was confident it could cope with a Phase 6
  pandemic.
• Lack of central government links to provincial,
  district, and lower levels of the system may make
  mitigation of a pandemic more difficult at those
  levels.

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Indonesia Country Report Findings

• Whole of Society Planning and Implementation
• Non-government agencies, both international and
  local civil society organizations have been very
  active in combating avian influenza at Pandemic
  Phases 1-4.
• Communities supported by these NGOs
  organizations are reported to be mobilized and
  prepared to prevent, control, and otherwise meet
  the challenges of influenza pandemics.
• The number of communities that may fall into this
  category of readiness, is unknown.

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Indonesia Country Report Findings

• Sector Planning and Continuity of Essential
  Services
• In public and private sectors concerned with
  provision of essential services, lack of
  coordinated planning and lack of readiness to
  meet the challenges of a severe pandemic were
  stark.
• One third of ministries, and 75 of the
  state-owned and private companies who were
  invited to participate in the Pilot Assessment
  were not accessible or declined.
• Only 2 of the 10 (20) sectors and essential
  services enterprises interviewed in the
  assessment had had experience with contingency or
  Business Continuity Planning.

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Indonesia Country Report FindingsSummary
Indonesia has achieved much in its efforts to
combat avian influenza at pandemic preparedness
and response Phases 1-4, particularly in the
animal and human health sectors. However,
Indonesia has not yet

Indonesia has achieved much in its efforts to
combat avian influenza for pandemic preparedness
and response Phases 1-4, particularly in the
animal and human health sectors. Indonesia is
still in the process of transitioning to a fully
functional multisectoral coordination modality.
In addition, further work will be required to
meet the guidelines established by the ASEAN
Indicators to respond in mitigating the impact,
or managing recovery from a severe Phase 6
scenario.
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Review of the Pilot Assessment Design and Process

• Approach and methodology
• Assessors were drawn from AMS and participated in
  the Pilot Assessment to lend support, and to gain
  experience.
• A Survey Questionnaire method was used to collect
  data, and the Questionnaire was based on the
  criteria, standards, and a quantitative country
  rating scale suggested by the ASEAN Indicators.
• The data gathering process was intended to be
  more of a self-assessment than an audit, but
  information was to be accompanied by source
  documents whenever possible.

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Review of the Pilot Assessment Design and Process

• Approach and methodology (contd)
• Both Assessors and Country Respondents were
  expected to be conversant with PPR issues and the
  purposes of the pilot assessment.
• Assessors received a 2-day training course in use
  of the assessment materials Assessors were
  accompanied by partner observers during a 2-day
  assessment and Assessors and observers
  participated in a 1-day summing up of findings
  from Indonesia, plus provided feedback on the
  Pilot Assessment design and process.

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Review of the Pilot Assessment Design and Process

• Feedback from Assessors and Observers
• Timing and scope of future assessments
• Modifications to approach and methodology
• Formation of teams and staff resources needed
• Training and preparation of assessors
• In-country preparations

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Timing and scope of future assessments

• Recommendation of the ASEAN-US Technical
  Assistance and Training Facility (TATF) Team
• Proceed as quickly as possible to the next phase,
  BUT modify approach and methodology.

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Modifications to Approach and Methodology

• Do not attempt national surveys.
• Change approach from one of quantitative
  assessment to one of strategic qualitative needs
  assessment.
• Engage policy makers in the process.
• Use interview format instead of survey
  questionnaire format.

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Formation of Teams and Technical Resources Needed

• Let policy makers help to identify key informants
  and Assessors.
• Add translation and interpreter capacity as
  needed.
• Add additional external resources.
• External resources should include professional
  technical writers.

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Training and preparations of Assessors

• Background documents on the country that are
  collected in preliminary visits should be used by
  Assessors in desk reviews to thoroughly
  familiarize themselves with the planning and
  program development environment in the country.
  This should be done before planning/scheduling
  begins.
• Assessors need more extensive training on
  technical knowledge related to PPR planning and
  coordination.
• Trainers need more extensive training on
  interview skills.
• The Lead Assessor should be selected on the basis
  of excellent interview skills, and need a
  standard report format to record notes.

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In-country preparations

• May require 1-3 advance visits over 3-4 months
  for each country for the following purposes
• Reach agreement with policy makers and
  focal/point organizers on assessment purpose and
  timing.
• Advance planning, scheduling, etc.
• Orientation/briefings of country respondents
  (possibly a pre-assessment workshop)

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In-country preparations (contd)

• 1st advance visit should include thorough
  orientation and collection of background
  documents related to external partners,
  government structures, operations/issues within
  sectors, and community/CSO activities to be used
  as briefing documents by Assessors.
• Country respondents should be thoroughly briefed,
  preferably before assessment begins, or at time
  of assessment.
• Country Respondents need to be given specific
  guidance on what documents they should have
  available for Assessors (not just an open-ended
  request).

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In-country preparations (contd)

• Some materials should be translated into local
  languages.
• Informants could be individuals rather than
  teams.
• Selected informants should be key
  representatives, and able to speak on behalf of
  the sector or organization they represent.
• Let policy makers have a say in who is included,
  and Assessors should be prepared to provide
  guidance on who is designated.

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Review of the Pilot Assessment Design and Process

• Feedback from Assessors and Observers
• Timing and scope of future assessments
• Modifications to approach and methodology
• Formation of teams and staff resources needed
• Training and preparation of assessors
• In-country preparations