IHR Monitoring and Evaluation Framework


The IHR Monitoring and Evaluation Framework provides an overview of approaches to review implementation of country core public health capacities under the IHR (2005). The Framework ensures the mutual accountability of States Parties and the Secretariat for global public health security through transparent reporting and dialogue.


Under the International Health Regulations(IHR) 2005 all States Parties are required to have or develop and maintain minimum core public health capacities to implement the IHR (2005), and report the status of implementation annually, as stipulated in Article 54 of the Regulations.

The formal submission of data from State Parties to the WHO via the IHR annual reports is very important and will be used as the basis for:

  • reporting to the World Health Assembly, on the status of implementation of these Regulations;
  • informing the GPW 13 indicator on emergency preparedness; and
  • informing UN SDG Goal 3 for indicator 3.d.1 – International Health Regulations (IHR) capacity and health emergency preparedness.

Detailed information on 2019 and previous years up to 2010 of the IHR annual reporting by State Parties are primarily published and available on e-SPAR platform and also at the WHO Global Health Observatory website

The Joint External Evaluation (JEE) is part of the IHR Monitoring and Evaluation Framework and is a voluntary, multi-sectoral process to assess country capacity to prevent, detect, and rapidly respond to public health risks. The JEE allows countries to identify the most urgent needs within their health security system; to prioritize opportunities for enhanced preparedness, detection and response capacity, including setting national priorities; and to allocate resources based on the findings.

A simulation exercise is a form of practice, training, monitoring or evaluation of capabilities, involving the description or simulation of an emergency to which a described or simulated response is made. Simulation exercises can develop and assess preparedness and response plans, procedures and systems for all hazards and capabilities. WHO defines different types of exercises, including discussion-based table top exercises as well as operations-based exercises such as drills, functional exercises and field/full scale exercises. Specifically, simulation exercises aim to:   

  1. Assess plans and procedures, operational guidelines and standard operating procedures;

  2. Assess interoperability between these plans and procedures;  

  3. Reveal planning weaknesses and resource gaps  

  4. Improve coordination and collaboration;  

  1. Clarify roles and responsibilities;  

  1. Practice and clarify chain of command;  

  1. Develop knowledge and skills for emergency response;  

  1. Familiarize staff with new functions and equipment 

  1. Gain recognition and trust in the emergency management processes. 

An After Action Review (AAR) is a qualitative review of actions taken to respond to an event as a means of identifying best practices, lessons and gaps in a country’s public health emergency preparedness and response capacity as part of a process of continual improvement and collective learning. Key stakeholders such as responders and decision-makers have the opportunity to reflect on what happened during the response, and share experiences to critically and systematically review what was in place before the response, what happened during the response, what went well and less well, why events occurred as they did, and how to institutionalize best practices and improve on gaps observed. Ultimately, the goal of the AAR is for individual and collective learning to be better prepared for the next public health event or emergency. AARs are conducted through the different formats of the AAR: Debrief AAR; Working group AAR; Key informant interview AAR; and Mixed-method AAR. For more information, please go to the official AAR WHO webpage.


Intra-Action Review 
In light of the protracted and unpredictable nature of the COVID-19 pandemic, countries may wish to conduct periodic reviews during the event so they can continue to reflect on the ongoing response and revise national and subnational response strategies and plans as needed to change the trajectory of the epidemic. WHO, having recognized this need, developed the Guidance for conducting a Country COVID-19 intra-action review (IAR) and accompanying tools. A Country COVID-19 Intra-Action Review (IAR) is a country-led facilitated process that allows stakeholders of the ongoing COVID-19 response to review the functional capacities of public health and emergency response systems at the national or subnational levels to identify best practices, gaps and lessons learned, and propose corrective measures and actions for immediate remediation or sustained improvement of the COVID-19 outbreak response. Although not an official component of the IHRMEF, intra-action reviews have been issued as one of the temporary recommendations to State Parties during the fourth meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19) convened by the WHO Director-General on 31 July 2020. Moving forward, there is also the opportunity to use intra-action reviews for other protracted public health events beyond COVID-19.