A novel phased approach to rapid response capacity strengthening in public health emergencies: Egypt's experience

Egypt's Ministry of Health and Population adopted the US Centers for Disease Control and Prevention's Analyze, Design, Develop, Implement, and Evaluate (ADDIE)-phased approach to strengthen and institutionalise rapid response teams (RRTs), moving beyond ad-hoc training toward sustainable systems. Using the Capacity Assessment Tool (CAT), Egypt identified operational and programmatic gaps, designed tailored workplans and implemented structured activities to enhance RRT readiness. This systematic process improved coordination, sustainability and capacity building, aligning with International Health Regulations and strengthening Egypt's overall preparedness and response to public health emergencies.

This longitudinal study measured RRT programme capacity and operational levels in Egypt from March 2022 to May 2023. Egypt RRT focal point and newly appointed managers used the CAT to evaluate 60 indicators across eight programmatic areas. The study used a before-and-after analysis of the three-phased interventions: RRT management training and Standard Operating Procedure development (July 2022), staffing and training of RRT (August 2022) and monitoring and evaluation (M&E) frameworks development (May 2023). Capacity and operational level scores measured across areas with scores ranging from 0 to 2 for each indicator.

Between baseline and the end of the intervention, the most significant improvements occurred in M&E (mean increase 1.80; p=0.001) and postdeployment (mean increase 1.50; p=0.007) capacity levels. For operational levels, statistically significant increases were observed across most areas, with the greatest improvements in postdeployment (1.33; p=0.01), activation and predeployment (1.27; p<0.001) and deployment (1.12; p=0.001). Results revealed that 41.7% of indicators showed two-point improvements in capacity, while 25% showed two-point improvements in operational levels. No indicators showed a decline in either capacity or operational performance.

The structured ADDIE-based phased approach demonstrated effectiveness in enhancing both capacity and operational levels of Egypt's RRT programme. Challenges persist in administrative considerations, highlighting the importance of addressing policy development and sustainable funding early in capacity building efforts. This approach offers a replicable framework for countries seeking to strengthen emergency response capabilities.