Is countries' transparency associated with gaps between countries' self and external evaluations for IHR core...

Area of Science:

• Global Health Security
• International Health Regulations
• Public Health Policy

Background:

• International Health Regulations (IHR) mandate core capacities for infectious disease control.
• Discrepancies exist between countries' self-reported IHR capacities and external evaluations.
• Understanding factors influencing these discrepancies is crucial for accurate global health security assessments.

Purpose of the Study:

• To evaluate the gap between self- and external-evaluations of core infectious disease control capacities.
• To identify factors influencing the gap between International Health Regulations Monitoring tool (IHRMT) and Joint External Evaluation (JEE) scores.
• To analyze the role of civil liberties, Human Development Index (HDI), and health workforce density (HWD) in this gap.

Main Methods:

• Collected IHRMT (self-evaluation) and JEE (external evaluation) scores for 2016 and 2017.
• Included data on civil liberties (CL), HDI, and HWD for 74 countries.
• Utilized chi-square tests and logistic regression to analyze correlations between evaluation gaps and influencing factors.

Main Results:

• Self-evaluation scores (IHRMT) decreased from 2016 to 2017.
• External evaluation scores (JEE) were consistently 1-1.5 points lower than self-evaluations.
• Higher HDI, CL, and HWD status were associated with larger gaps; higher HDI significantly increased the risk of a larger gap (OR=3.181).

Conclusions:

• Country transparency (CL status) influences the IHR-JEE score gap.
• Human Development Index (HDI) status is a key factor significantly associated with the evaluation gap.
• The primary driver of the gap involves differing interpretations in high-HDI countries, with lower CL countries tending to overstate their capacities.