Implementation Guidance

PHSM Decision Navigator

In times of public health crises, leaders and decision-makers face immense pressure to act quickly and effectively. Their choices regarding public health and social measures (PHSM) must not only protect communities but also minimize disruptions to daily life and the economy. Their decisions on selecting and adjusting PHSM during public health emergencies require careful consideration of a complex array of factors, including the epidemiological situation, health system capacity, availability of medical countermeasures, along with resource availability, political and legal feasibility and public acceptance of the PHSM being considered. WHO has developed the PHSM Decision Navigator to provide a clear, systematic, and equitable framework for making these critical decisions.

The Navigator is a threat-agnostic decision framework that outlines a step-by-step decision pathway to guide national and subnational governments in systematically considering multiple complex factors to define a PHSM implementation package – a combination of PHSM paired with corresponding mitigation measures, which are social protection policies and community-based initiatives crucial for reducing unintended negative consequences of PHSM implementation. This package is essential for safeguarding both lives and livelihoods, ensuring business and education continuity and bolstering community resilience during public health emergencies.

The Navigator’s decision pathway begins once an initial risk assessment has been conducted and guides decision-makers through a series of interconnected, dynamic steps after they determine the reliance on PHSM for an effective response:

1. Select list of PHSM based on risks and evidence of effectiveness.
2. Balance feasibility, unintended negative consequences of PHSM policies, and corresponding mitigation measures of each PHSM.
3. Optimize and finalize the PHSM implementation package, which consists of a targeted, balanced combination of PHSM and corresponding mitigation measures.
4. Implement the PHSM implementation package, utilizing enabling functions such as risk communication and community engagement and infodemic management.
5. Monitor the PHSM policies being implemented, the unintended negative consequences and social acceptance of PHSM, and evaluate PHSM effectiveness.
6. Adjust PHSM as needed based on contextually relevant factors (e.g. epidemiology, health system capacity, population immunity, availability of medical countermeasures, social acceptability).

WHO is developing a country support tool to guide decision-makers through the complexities of formulating, implementing and adjusting PHSM policies during health emergencies.

The tool will aim to facilitate systematic consideration of numerous factors that influence effective PHSM implementation and adjustment during health emergencies, such as epidemiological patterns, the availability of medical countermeasures, health system capacity and the socioeconomic context.