Guidance for Public Health Units about the core capacities required at New Zealand international airports under the International Health Regulations (2005) Purpose

• 
  Use a staged approach, planned out over reasonable time frames (see CPH approach above). A sound assessment requires detailed planning up front.
  
• 
  Read the IHR and take time to learn and understand the IHR core capacity assessment tool. For example, while there might appear to be some overlaps in the assessment tool, they are there for a reason (e.g., Section C2: Training for inspectors and Section D2: Inspection programmes of the ‘capacities at all times’ spreadsheet have similar looking line items, but one is focused on the training of inspectors while the other on the programmes themselves). WHO has developed a paper on the assessment tool and an electronic Excel Speadsheet version is available from the WHO website (see the references section below).
  
• 
  Be confident in its application, but seek advice from the MoH or your colleagues from other PHUs on interpretation if needed.
  
• 
  Develop a Compliance Index/register up front (see CPH’s model).
  
• 
  Pool information and experiences across the PHU.
  
• 
  Ensure peer support and review when needed.
  

(Refer to assessment tool for comprehensive list)

• 
  Know the core physical location of the key parts of POE (e.g., the first aid room and capacity to separate/treat travellers, the Airport Fire Service/Emergency Service, location of agencies offices, waste points, food premises, etc).
  
• 
  Look for opportunities to influence POE design from a health perspective (e.g., non touch taps).
  

(Refer to response plan for comprehensive list)

• 
  The Airport Company – Know what it does and how it operates (e.g., reliance on a range of sub-contractors to do components of the core capacities)?
  
• 
  What contractors are used for different functions (water and waste, vector, cleaning, etc)?
  
• 
  There may be more than one subcontractor doing the same role (e.g., CIAL had three different ground handling companies).
  

• 
  You need to be realistic – a balanced approach is needed between protecting public health and recognising the commercial imperatives that operate in the transport/traveller focussed point of entry.
  
• 
  Time is money – delaying or interfering with transport and trade without a sound and justifiable reason will cause problems for all.
  
• 
  Be sensitive to time demands on operators during the assessment process.
  

• 
  Some core areas include cleaning, sanitation verification, water and waste verification, integrated vector control, correct use of personal protective equipment, etc.
  
• 
  Try to find common ground or show how a health outcome is relevant to POE’s business or can add value (e.g., travellers expect clean and sanitary conditions and will judge POE on such things).
  

• 
  Commencing development of compliance register/index.
  
• 
  Start to develop a Task Matrix to allocate responsibility to the required tasks, (see attached example of a Task Matrix).
  
• 
  Roles should be defined, agreed to, and clearly documented.
  
• 
  Recognise links with partners outside the POE environment (e.g., NZ’s IHR National Focal Point is the Director of Public Health in the MoH. PHU staff need to understand what the role of the NFP is and the reporting pathway (HPO, Medical Officer of Health, Director of Public Health, WHO).
  
• 
  PHU staff need to ensure there is clinical input/support into decision-making, risk assessment and disease management.
  
• 
  If in doubt about who should be responsible for any core capacity, raise the issue with the MoH.
  

• 
  Actively seek involvement with existing airport standing committees to promote health issues – especially Health and Safety Committees where a wide range of stakeholders will be present. Use these opportunities to brief stakeholders on IHR POE core capacity requirements and to get health issues on the table or offer advice and support (e.g., delivering of PPE training, basic training tool on infection control key points, etc).
  
• 
  Continue networking via other channels outside such standing groups.
  

• 
  Meet people, remember their names, confirm their details, and understand their roles
  
• 
  Spend time with them (e.g., ground handlers).
  

• 
  Tap into the existing communications networks at POEs and respond promptly when asked for input.
  
• 
  Determine the most appropriate communication channels in POE (e.g., essential training to border agencies and operators – such as recommendations for the use of PPE).
  

• 
  Pre-assessment engagement helps pave the way (informal).
  
• 
  Develop checklists of the key questions to ask (discuss with CPH about what they did).
  
• 
  Try to involve PHU staff with skills in auditing or undertaking assessments.
  
• 
  Populate the assessment tool, but don’t reinvent the wheel – e.g., in many places you can populate the tool with simple cross references to other existing documents and tools, which adequately cover off issues (PHRMP for water supply, Airport Response Plans, etc).
  
• 
  Obtain copies of relevant SOPs during the assessment, or other documented proof to give you greater assurance that a core capacity is being met.
  
• 
  Just because a procedure is documented doesn’t mean it is being complied with, do not assume anything, – additional checks could be needed (e.g., ask for a recent example to show it was followed).
  

• 
  Provide the completed assessment tool to key stakeholders and seek feedback.
  
• 
  Identify and rectify gaps and overlaps.
  
• 
  Consult guidance provided by WHO/ICAO and other international agencies in relation to the IHR (2005).
  
• 
  Work with POE to develop action plans to remedy deficiencies or weaknesses found in the assessments (review progress and at appropriate intervals).
  
• 
  Confirm that deficiencies found by the assessment tool are remedied.
  
• 
  Communicate major findings or concerns about progress to the Ministry.
  

• 
  Skills in audit processes and good knowledge of communicable diseases and infection control.
  
• 
  Core Environmental Health competencies e.g. drinking water, waste, food, vector control.
  
• 
  CPH found a team approach worked best (rather than one person) – brings a suite of skills, enables internal peer review, helps ensure knowledge and skill retention).