Establishing a Foundation for Performance Measurement for Local Public Health Preparedness.

The development of performance measures is not a new concept in the disaster preparedness space. For over a decade, goals have been developed and tied to federal preparedness grant programs. However, these measures have been heavily criticized for their inability to truly measure preparedness. There is also growing frustration at the local level that these performance measures do not account for local readiness priorities or the outcome-driven value of emergency response activities. To define an appropriate theoretical framework for the development of performance measures, a review of the literature on existing planning and preparedness frameworks was conducted, with an iterative feedback process with a local health agency. This paper presents elements of that literature review that were most directly along with the conceptual framework that was used as a starting point for future iterations of a comprehensive performance measure development project.

Improving epidemic malaria planning, preparedness and response in Southern Africa. Report on the 1st Southern African Regional Epidemic Outlook Forum, Harare, Zimbabwe, 26-29 September, 2004.

Malaria is a major public health problem for countries in the Southern Africa Development Community (SADC). While the endemicity of malaria varies enormously across this region, many of the countries have districts that are prone to periodic epidemics, which can be regional in their extent, and to resurgent outbreaks that are much more localized. These epidemics are frequently triggered by climate anomalies and often follow periods of drought. Many parts of Southern Africa have suffered rainfall deficit over the past three years and countries expect to see increased levels of malaria when the rains return to more 'normal' levels. Problems with drug and insecticide resistance are documented widely and the region contains countries with the highest rates of HIV prevalence to be found anywhere in the world. Consequently, many communities are vulnerable to severe disease outcomes should epidemics occur. The SADC countries have adopted the Abuja targets for Roll Back Malaria in Africa, which include improved epidemic detection and response, i.e., that 60% of epidemics will be detected within two weeks of onset, and 60% of epidemics will be responded to within two weeks of detection. The SADC countries recognize that to achieve these targets they need improved information on where and when to look for epidemics. The WHO integrated framework for improved early warning and early detection of malaria epidemics has been recognized as a potentially useful tool for epidemic preparedness and response planning. Following evidence of successful adoption and implementation of this approach in Botswana, the SADC countries, the WHO Southern Africa Inter-Country Programme on Malaria Control, and the SADC Drought Monitoring Centre decided to organize a regional meeting where countries could gather to assess their current control status and community vulnerability, consider changes in epidemic risk, and develop a detailed plan of action for the forthcoming 2004-2005 season. The following is a report on the 1st Southern African Regional Epidemic Outlook Forum, which was held in Harare, Zimbabwe, 26th-29th September, 2004.