From 25 to 28 June 2024, Sri Lanka initiated the capacity building package rollout for Health Emergency Operations Centres (HEOC) in line with the International Health Regulations (IHR) 2005 requirements to develop, strengthen and maintain their capacities to respond promptly and effectively to public health risks and emergencies in a collaborative effort with Disaster Preparedness and Response Division of Ministry of Health, WHO and Robert Koch Institute (RKI), Germany. The overall objective of the capacity building efforts is to strengthen the capacities of the national and subnational Health Emergency Operations Centres (HEOCs) to effectively and efficiently prepare for and respond to health emergencies in Sri Lanka.
A capacity building needs assessment was conducted prior to the detailed planning process for project activities. The assessment, which included national and subnational experts and participants, identified the current status of the national and subnational HEOCs and set priorities for the country-specific adaptation of the business continuity plan.
Based on the results of the capacity building needs assessment a 3-day capacity building workshop was held for 37 national and sub national participants with an additional day for skill building for master training. The sub-objectives of country-specific capacity building workshops included an analysis of areas which need strengthening to structure roadmaps at sub-national level for further improvement, and the development of guiding documents such as the HEOC handbook for national and sub-national levels which are needed to efficiently operate HEOCs.
The Joint External Evaluation of the IHR core capacities conducted in 2023 identified the need to extend the subnational HEOC coverage, capacity and auditing to all districts in a phased manner based on risk.
To achieve the mandates of the IHR (2005) and to address health consequences of emergencies, Member States (MS) in the South-East Asia Region of WHO have been improving their HEOCs and/or established dedicated HEOCs within their Ministries of Health to strengthen communication and coordination during public health response. While the initial focus has been placed on information and communication technology (ICT) and the physical HEOC infrastructure, the effective activation and operation of a HEOC equally depends on adequate plans, procedures and protocols. These need to be known, exercised and adapted on a regular basis.
The National Health Emergency Operations Centre (NHEOC) in Sri Lanka was established in 2004 in the aftermath of the tsunami and the physical NHEOC at the premises of the Ministry of Health was established in 2008. Since then, eight subnational Health Emergency Operations centres were established in the most vulnerable districts.
The National Action Plan for Health Security (NAPHS) Strategic Plan 2024-2028 and the two-year operational plan identified the need for strengthening of NHEOC and sub-national HEOCs through a capacity building needs assessment, and country-specific modules developed for training, while the standard operative procedure for HEOC developed in 2019 needs to be updated and the procedures needing to be practiced through simulation exercises.
The Robert Koch Institute has a long-standing experience in the planning, setting up and operation of a HEOC at the national level, as well as in providing HEOC-related training and simulation exercises at both national and international level. In 2021, Project on Training for Health Emergency Operations Centres II (ProTECt II) started the piloting phase of a HEOC capacity building package (CBP).
The CBP aimed to a) refresh knowledge on international HEOC standards and b) assess the existing setup of the national and subnational HEOC and develop roadmaps for the sub national-level.
The scope of training for HEOC based on the assessment included HEOC principles and core components, risk assessment and operations readiness, incident management system, incident action plan, HEOC roles and functions learning experience from RKI, regional and Sri Lanka experience, HEOC modes of operation (watch, alert, response), surge response capacities, HEOC activation and deactivation, monitoring and evaluation, after action reviews and a tabletop simulation exercise.
The priorities that need to be further enhanced following the initial training was identified by the participants. These include expanding the training for the districts not included in the current training, cascading training for technical staff from the districts that core staff were trained, finalizing the HEOC handbook for national and subnational level, following up on the sub-national roadmaps developed and a functional simulation exercise to be conducted within six months to assess the overall effect of all the capacity building activities. This list of priorities will guide the future activities to strengthen HEOC capacities within the ProTECt project in 2025.
Note:
A Health Emergency Operations Centre (HEOC) is a hub for the coordination of information and resources to support incident management activities, and integrates traditional public health services into an emergency management model. It supports health sector at national and sub national level and is a component of existing national disaster management authorities or entities. The HEOC plays a critical role in preparedness and response activities to health emergencies. In 2015, WHO published the “Framework for a Public Health Emergency Operations Centre” which outlines the key concepts and essential requirements for developing and managing a HEOC.
