Reviewing Health Security Capacities in Nigeria Using the Updated WHO Joint External Evaluation and WHO Benchmarks Tool: Experience from a Country-Led Self-Assessment Exercise

Olukayode Fasominu*, Oyeladun Okunromade, Oyeronke Oyebanji, Christopher T. Lee, Adejare Atanda, Ibrahim Mamadu, Ifeanyi Okudo, Ebere Okereke, Elsie Ilori, Chikwe Ihekweazu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Across the world, the level of pandemic preparedness varies and no country is fully prepared to respond to all public health events. The International Health Regulations 2005 require state parties to develop core capacities to prevent, detect, and respond to public health events of international concern. In addition to annual self-assessment, these capacities are peer reviewed once every 5 years through the voluntary Joint External Evaluation (JEE). In this article, we share Nigeria's experience of conducting a country-led midterm self-assessment using a slightly modified application of the second edition of the World Health Organization (WHO) JEE and the new WHO benchmarks tool. Despite more stringent scoring criteria in the revised JEE tool, average scoring showed modest capacity improvements in 2019 compared with 2017. Of the 19 technical areas assessed, 11 improved, 5 did not change, and 3 had lower scores. No technical area attained the highest-level scoring of 5. Understanding the level of, and gaps in, pandemic preparedness enables state parties to develop plans to improve health security; the outcome of the assessment included the development of a 12-month operational plan. Countries need to intentionally invest in preparedness by using existing frameworks (eg, JEE) to better understand the status of their preparedness. This will ensure ownership of developed plans with shared responsibilities by all key stakeholders across all levels of government.

Original languageEnglish
Pages (from-to)74-86
Number of pages13
JournalHealth Security
Issue number1
Publication statusPublished - 1 Feb 2022

Bibliographical note

Funding Information:
The authors would like to acknowledge the active participation of national experts in preparing for the midterm JEE mission. We also recognize the invaluable partnerships with governments including the governments of the United Kingdom and the United States for providing technical experts for this country-led review process; with other intergovernmental organizations, particularly FAO, OIE, West Africa Health Organization, Resolve to Save Lives, World Bank, Georgetown University, Public Health England, US Centers for Disease Control and Prevention, Pro-Health International, African Field Epidemiology Network, Volte Health, and University of Maryland, Baltimore for their contribution of expertise. We appreciate the financial support provided by Resolve to Save Lives and Public Health England for this activity and the WHO Nigeria Country Office for technical, planning, and financial support. The authors would like to acknowledge the continuing support and commitment of all of these to the implementation and principles of the IHR.

Publisher Copyright:
© 2021 Olukayode Fasominu, et al. Published by Mary Ann Liebert, Inc.


  • International Health Regulations
  • Joint External Evaluation
  • Preparedness
  • Public health preparedness/response


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