Using the WHO building blocks to examine cross-border public health surveillance in MENA

Abstract The introduction of the Sustainable Development Goals by the United Nations has set a global target for achieving Universal Health Coverage, requiring resilient health systems capable of addressing public health emergencies and ensuring health security. Public health surveillance, crucial f...

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Main Authors: Laura Buback, Shayanne Martin, Esbeydy Pardo, Farah Massoud, Jesus Formigo, Atousa Bonyani, Noha H. Farag, Zayid K. Almayahi, Kenta Ishii, Susie Welty, Dana Schneider
Format: Article
Language:English
Published: BMC 2025-02-01
Series:International Journal for Equity in Health
Subjects:
Online Access:https://doi.org/10.1186/s12939-025-02393-7
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author Laura Buback
Shayanne Martin
Esbeydy Pardo
Farah Massoud
Jesus Formigo
Atousa Bonyani
Noha H. Farag
Zayid K. Almayahi
Kenta Ishii
Susie Welty
Dana Schneider
author_facet Laura Buback
Shayanne Martin
Esbeydy Pardo
Farah Massoud
Jesus Formigo
Atousa Bonyani
Noha H. Farag
Zayid K. Almayahi
Kenta Ishii
Susie Welty
Dana Schneider
author_sort Laura Buback
collection DOAJ
description Abstract The introduction of the Sustainable Development Goals by the United Nations has set a global target for achieving Universal Health Coverage, requiring resilient health systems capable of addressing public health emergencies and ensuring health security. Public health surveillance, crucial for detecting and responding to infectious disease outbreaks, is key to building health system resilience. Due to the high levels of mobility and political instability in the Middle East and North Africa (MENA) region, unique challenges arise in cross-border health surveillance. This review aims to highlight the importance of cross-border public health surveillance in strengthening health systems across MENA to achieve equitable health outcomes. A mixed-methods approach was utilized, combining a systematic literature review with semi-structured in-depth interviews (IDIs) involving 28 stakeholders from seven MENA countries. The literature review adhered to PRISMA guidelines, while the IDIs provided qualitative insights into current surveillance practices and challenges. Findings from the literature review and IDIs were triangulated and analyzed using the WHO Health Systems Strengthening (HSS) Building Blocks Framework to identify key challenges and recommendations for improving cross-border surveillance. Results indicate that existing cross-border surveillance systems in MENA face challenges in data collection, analysis, and sharing, with disparities across countries based on income levels and political contexts. Key challenges include delayed and incomplete data sharing, insufficient funding across sectors, inadequate training, inconsistent data definitions, and limited integration of health data for mobile populations. Recommendations emphasize strengthened governance and leadership to facilitate regional cooperation and information sharing, sustainable financing for implementing a One Health approach, utilizing innovative information systems, workforce development to enhance data collection and analysis, and secure supply chains for medicines and vaccines and equitable service delivery for all mobile populations. In conclusion, the WHO HSS Building Block Framework provides a comprehensive approach to assessing and improving cross-border public health surveillance and enhancing health security and equity in MENA. Strengthening cross-border surveillance systems may help MENA countries meet IHR requirements, achieve greater health security, and advance health equity among all types of mobile populations. Despite limitations, the study offers critical insights for improving cross-border surveillance strategies in the region.
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spelling doaj-art-17f3677245794c37b7ef1061f35fc0122025-02-09T12:26:10ZengBMCInternational Journal for Equity in Health1475-92762025-02-0124111610.1186/s12939-025-02393-7Using the WHO building blocks to examine cross-border public health surveillance in MENALaura Buback0Shayanne Martin1Esbeydy Pardo2Farah Massoud3Jesus Formigo4Atousa Bonyani5Noha H. Farag6Zayid K. Almayahi7Kenta Ishii8Susie Welty9Dana Schneider10University of California San Francisco (UCSF)University of California San Francisco (UCSF)University of California San Francisco (UCSF)University of California San Francisco (UCSF)University of California San Francisco (UCSF)University of California San Francisco (UCSF)U.S. Centers for Disease Control and Prevention (CDC), Middle East & North Africa Regional OfficeU.S. Centers for Disease Control and Prevention (CDC), Middle East & North Africa Regional OfficeCenters for Disease Control and Prevention (CDC)University of California San Francisco (UCSF)Centers for Disease Control and Prevention (CDC)Abstract The introduction of the Sustainable Development Goals by the United Nations has set a global target for achieving Universal Health Coverage, requiring resilient health systems capable of addressing public health emergencies and ensuring health security. Public health surveillance, crucial for detecting and responding to infectious disease outbreaks, is key to building health system resilience. Due to the high levels of mobility and political instability in the Middle East and North Africa (MENA) region, unique challenges arise in cross-border health surveillance. This review aims to highlight the importance of cross-border public health surveillance in strengthening health systems across MENA to achieve equitable health outcomes. A mixed-methods approach was utilized, combining a systematic literature review with semi-structured in-depth interviews (IDIs) involving 28 stakeholders from seven MENA countries. The literature review adhered to PRISMA guidelines, while the IDIs provided qualitative insights into current surveillance practices and challenges. Findings from the literature review and IDIs were triangulated and analyzed using the WHO Health Systems Strengthening (HSS) Building Blocks Framework to identify key challenges and recommendations for improving cross-border surveillance. Results indicate that existing cross-border surveillance systems in MENA face challenges in data collection, analysis, and sharing, with disparities across countries based on income levels and political contexts. Key challenges include delayed and incomplete data sharing, insufficient funding across sectors, inadequate training, inconsistent data definitions, and limited integration of health data for mobile populations. Recommendations emphasize strengthened governance and leadership to facilitate regional cooperation and information sharing, sustainable financing for implementing a One Health approach, utilizing innovative information systems, workforce development to enhance data collection and analysis, and secure supply chains for medicines and vaccines and equitable service delivery for all mobile populations. In conclusion, the WHO HSS Building Block Framework provides a comprehensive approach to assessing and improving cross-border public health surveillance and enhancing health security and equity in MENA. Strengthening cross-border surveillance systems may help MENA countries meet IHR requirements, achieve greater health security, and advance health equity among all types of mobile populations. Despite limitations, the study offers critical insights for improving cross-border surveillance strategies in the region.https://doi.org/10.1186/s12939-025-02393-7Border healthCross-border surveillanceMiddle EastNorth AfricaHealth systems strengtheningMobile populations
spellingShingle Laura Buback
Shayanne Martin
Esbeydy Pardo
Farah Massoud
Jesus Formigo
Atousa Bonyani
Noha H. Farag
Zayid K. Almayahi
Kenta Ishii
Susie Welty
Dana Schneider
Using the WHO building blocks to examine cross-border public health surveillance in MENA
International Journal for Equity in Health
Border health
Cross-border surveillance
Middle East
North Africa
Health systems strengthening
Mobile populations
title Using the WHO building blocks to examine cross-border public health surveillance in MENA
title_full Using the WHO building blocks to examine cross-border public health surveillance in MENA
title_fullStr Using the WHO building blocks to examine cross-border public health surveillance in MENA
title_full_unstemmed Using the WHO building blocks to examine cross-border public health surveillance in MENA
title_short Using the WHO building blocks to examine cross-border public health surveillance in MENA
title_sort using the who building blocks to examine cross border public health surveillance in mena
topic Border health
Cross-border surveillance
Middle East
North Africa
Health systems strengthening
Mobile populations
url https://doi.org/10.1186/s12939-025-02393-7
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