COVID-19 Intra-Action Review (IAR)
2021
The Intra-Action Review (IAR) was developed by the World Health Organization. It is a country-led periodic review of actions used to assess the response of countries to the COVID-19 outbreak and aims to identify the best strategy and lessons learned to sustain improvement. The findings are acquired by conducting the customizable tool by WHO, which includes, but is not limited to, a generic presentation, open-ended questions, and a final report to provoke discussion. Moreover, it could be a structural public health guide beyond this current pandemic.
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The novel coronavirus outbreak was declared a public health emergency on January 30, 2020, by the WHO. The rapid transmission of the virus forced a sudden lockdown, and the resulting global economic recession further demands that public health experts implement immediate response through continual development of a COVID-19 risk management strategy to instigate preparedness and fast recovery.
The IAR is a temporary recommendation during the International Health Regulations (2005) Emergency Committee’s fourth meeting, assembled by the WHO. It is a well-documented and shared collective learning to allow national and subnational teams to reflect on COVID-19 response efficiency and eliminate a passive approach while strengthening new strategies.
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Importance of Intra-Action Review (IAR)
The Intra-Action Review (IAR) provides an opportunity to analyze the public health capacity to remediate the outbreak. The compiled actions are examined for continuous updates of the strategic response plan to identify the best practices and prevent recurrent errors. WHO encourages to conduct of IAR to induce accountability of leaders to support immediate response and improve operational planning to increase the resiliency of the country towards the pandemic.
IAR also serves as a guide for better decision-making. The emerging evidence to respond efficiently to evolving epidemiological situations, to develop a new direction, and the changes in priorities have renewed the allocation of budget from the government to fulfill new commitments for public health safety. Therefore, it is an important exercise to maintain appropriate actions and institutionalize effective practices for national preparedness.
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How is IAR conducted?
The WHO developed customizable tools which include, but are not limited to, templates, concept notes, questionnaires, generic presentations, and a facilitator’s manual to conduct the intra-action review. The countries involved are encouraged to share experiences and newly discovered appropriate strategies to enhance the implied practices; in fact, this process is aligned with WHO’s COVID-19 Strategic Preparedness and Response Plan.
The government institution defines the scope of planning and implementation which is considered the first step. Those authorities further decide the period to be analyzed and the pillars to review, varied on vaccination roll-out process, epidemiology surveillance, infection prevention and control, community engagement, coordination, health services capacity, points of entry, and national laboratory system. These are ideally assessed online to avoid unnecessary interaction.
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Selection of participants
Diversity of opinion is an important factor to ensure the quality of IAR. Hence, the 10 to 20 participants are from a wide range of expertise that productively promotes discussion and recommendations. They also have first-hand experience, depth of knowledge, and responsibility in the reviewed target pillar.
IAR is conducted on a whole society approach and exercised with coordinated institutions deciding on the selection of relevant participants, including external facilitators and observers, while the WHO regional office, headquarters, and country offices ensure the necessary support in planning.
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Current IAR status in different countries
According to the data of the WHO, the current percentage of implemented IAR is 60.5% in the African region, 3.1% in the Americas region of the Americans, 10.9% in the Eastern Mediterranean Region, 11.6% in the European Region, 8.5% in the South-East Asian Region, and 5.4% in the Western Pacific Region.
Countries in the currently planned status are New Zealand, Morocco, Greece, Chad, Sudan, South Sudan, Central African Republic, Cameroon, United Republic of Tanzania, Angola, Namibia, Zimbabwe, Myanmar, Jordan, Tunisia, Georgia, Azerbaijan, Malawi, Madagascar, South Africa, Papua New Guinea, Oman, Lesotho, Guinea, and Côte d'Ivoire
While countries with conducted status are Brazil, Bolivia, Ethiopia, Indonesia, Thailand, Cambodia, Lao People’s Democratic Republic, Vietnam, Germany, Latvia, Ukraine, Syrian Arab Republic, Afghanistan, Pakistan, India, Kyrgyzstan, Uzbekistan, Bangladesh, Mongolia, Nigeria, Gabon, the Democratic Republic of the Congo, Zambia, Botswana, Malawi, Mozambique, Uganda, Kenya, Somalia, Niger, Benin, Burkina Faso, Ghana, Mali, Mauritania, and Senegal.
Other countries that are not mentioned have no available data.
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Bottom Line
The Intra-Action Review instigates fast recovery and continual learning for the appropriate COVID-19 response. The associated tools assess the practices to further reflect and improve the existing strategies. This process enabled collaboration between countries to immediately apply the lessons learned and emphasize the appropriate actions.
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