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Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region

Ground crossing borders in the Middle East and North Africa (MENA) region are vital for trade, migration, and humanitarian relief, yet they remain critical weak points in global health security. Their vulnerability stems from fragile infrastructure, limited resources, and weak surveillance systems,...

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Main Author: Sami, Diana Guirguis
Format: Thesis
Published: AUC Knowledge Fountain 2025
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access_status_str Open Access
author Sami, Diana Guirguis
author_browse Sami, Diana Guirguis
author_facet Sami, Diana Guirguis
author_sort Sami, Diana Guirguis
collection Thesis
description Ground crossing borders in the Middle East and North Africa (MENA) region are vital for trade, migration, and humanitarian relief, yet they remain critical weak points in global health security. Their vulnerability stems from fragile infrastructure, limited resources, and weak surveillance systems, exacerbated by conflict, climate-related disasters, and rising forced migration. These dynamics increase disease transmission and overwhelm national health systems. Although the International Health Regulation IHR 2005 require countries to build core public health capacities at Points of Entry (PoEs), implementation at land borders remains challenging due to their porous and complex environments. This study aims to identify key pillars of effective border health management, assess health core capacities on the land borders in selected MENA countries, and explore implementation challenges and solutions from expert perspectives. A scoping review was conducted using Arksey and O’Malley’s framework and PRISMA-ScR guidelines, covering literature from 2005 to 2023 across PubMed, Scopus, Web of Science, and UN databases. Forty-five eligible studies were grouped into eight thematic areas. These themes informed a descriptive exploratory survey targeting public health and border management professionals across the region. The survey assessed the current status of IHR (2005) core capacities through eight themes: Infection Prevention and Control (IPC), Coordination and Partnerships, Research and Data Sharing, Border Health Capacity, Planning, Communication, Legal Frameworks, and Services for At-Risk Groups. Responses were analyzed both quantitatively and qualitatively. The scoping review identified eight interlinked themes essential for effective border health management. The survey findings revealed an average IHR (2005) readiness of 46% among selected MENA countries, with most thematic areas showing significant gaps. Stronger performance was linked to targeted investment in health security rather than overall economic strength. The most critical deficiencies were found in surveillance and data-sharing systems, indicating weak knowledge exchange and evidence-driven planning. Other thematic areas— including IPC, emergency planning, legal frameworks, and support for vulnerable populations—also showed substantial weaknesses, underscoring the need for systemic reforms. Ground crossings in the MENA region are underprepared to manage cross-border health threats. Their complexity requires tailored approaches beyond the current IHR (2005) assessment tools. Strengthening IHR implementation will depend on context-specific strategies: revising assessment frameworks to reflect ground realities, expanding digital surveillance, building workforce capacity, and improving regional coordination. Sustainable funding and integrated, multisectoral approaches are essential to enhance health preparedness and migration response. This study offers evidence-based insights and actionable recommendations to improve health security at land borders in fragile settings.
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provenance_str_mv Harvested via OAI-PMH from AUC Knowledge Fountain — bepress
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spelling oai:fount.aucegypt.edu:etds-3561 Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region Sami, Diana Guirguis Ground crossing borders in the Middle East and North Africa (MENA) region are vital for trade, migration, and humanitarian relief, yet they remain critical weak points in global health security. Their vulnerability stems from fragile infrastructure, limited resources, and weak surveillance systems, exacerbated by conflict, climate-related disasters, and rising forced migration. These dynamics increase disease transmission and overwhelm national health systems. Although the International Health Regulation IHR 2005 require countries to build core public health capacities at Points of Entry (PoEs), implementation at land borders remains challenging due to their porous and complex environments. This study aims to identify key pillars of effective border health management, assess health core capacities on the land borders in selected MENA countries, and explore implementation challenges and solutions from expert perspectives. A scoping review was conducted using Arksey and O’Malley’s framework and PRISMA-ScR guidelines, covering literature from 2005 to 2023 across PubMed, Scopus, Web of Science, and UN databases. Forty-five eligible studies were grouped into eight thematic areas. These themes informed a descriptive exploratory survey targeting public health and border management professionals across the region. The survey assessed the current status of IHR (2005) core capacities through eight themes: Infection Prevention and Control (IPC), Coordination and Partnerships, Research and Data Sharing, Border Health Capacity, Planning, Communication, Legal Frameworks, and Services for At-Risk Groups. Responses were analyzed both quantitatively and qualitatively. The scoping review identified eight interlinked themes essential for effective border health management. The survey findings revealed an average IHR (2005) readiness of 46% among selected MENA countries, with most thematic areas showing significant gaps. Stronger performance was linked to targeted investment in health security rather than overall economic strength. The most critical deficiencies were found in surveillance and data-sharing systems, indicating weak knowledge exchange and evidence-driven planning. Other thematic areas— including IPC, emergency planning, legal frameworks, and support for vulnerable populations—also showed substantial weaknesses, underscoring the need for systemic reforms. Ground crossings in the MENA region are underprepared to manage cross-border health threats. Their complexity requires tailored approaches beyond the current IHR (2005) assessment tools. Strengthening IHR implementation will depend on context-specific strategies: revising assessment frameworks to reflect ground realities, expanding digital surveillance, building workforce capacity, and improving regional coordination. Sustainable funding and integrated, multisectoral approaches are essential to enhance health preparedness and migration response. This study offers evidence-based insights and actionable recommendations to improve health security at land borders in fragile settings. 2025-05-01T07:00:00Z dissertation application/pdf https://fount.aucegypt.edu/etds/2513 https://fount.aucegypt.edu/context/etds/article/3561/viewcontent/Diana_Guirguis_Sami_thesis.pdf Theses and Dissertations AUC Knowledge Fountain IHR; Emergency Preparedness and Response; Ground Border Crossings; Health Border Management; Public Health Security; MENA Region Health and Medical Administration Medical Humanities Public Affairs, Public Policy and Public Administration Public Health Sociology
spellingShingle IHR; Emergency Preparedness and Response; Ground Border Crossings; Health Border Management; Public Health Security; MENA Region
Health and Medical Administration
Medical Humanities
Public Affairs, Public Policy and Public Administration
Public Health
Sociology
Sami, Diana Guirguis
Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title_full Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title_fullStr Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title_full_unstemmed Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title_short Challenges for Implementing a Health Security Model in the Ground Border Crossings in the MENA Region
title_sort challenges for implementing a health security model in the ground border crossings in the mena region
topic IHR; Emergency Preparedness and Response; Ground Border Crossings; Health Border Management; Public Health Security; MENA Region
Health and Medical Administration
Medical Humanities
Public Affairs, Public Policy and Public Administration
Public Health
Sociology
url https://fount.aucegypt.edu/etds/2513
https://fount.aucegypt.edu/context/etds/article/3561/viewcontent/Diana_Guirguis_Sami_thesis.pdf
work_keys_str_mv AT samidianaguirguis challengesforimplementingahealthsecuritymodelinthegroundbordercrossingsinthemenaregion