1. Training needs related to core capacities at points of entry in Europe, 2014
Despena Andrioti, Carmen Varela Matinez, Francisco Nogareda, Miguel Davila,
Barbara Mouchtouri and Christos Hadjichristodoulou for the SHIPSAN partnership

2. Content Background Objectives Methods Results and Discussion
Conclusions

3. Background

4. EU SHIPSAN ACT Joint Action - The history
Situation analysis and needs assessment
Addressing passenger ships
State of the art: Communicable diseases & outbreaks from 1970 to 2006
EU MS categorised in 4 groups according to their capacity
Study: 32 countries and 176 authorities
Needs, gaps, legislation
Use experience of existing programmes
Manual for health and hygiene - outline
Development of materials and establishment of training network
Manual for health and hygiene
Training network and pool of experts
Training material
Training modules for PHO & seafarers
EU SHIPSAN Integrated Program/pilot inspections
Web-based Communication Network
Joint Action for all types of threats in maritime transport
Cargo ships
Inland navigation vessels
Fishing vessels
Passenger ships

5. SHIPSAN ACT JA EU SHIPSAN ACT Joint Action – General objective
To strengthen an integrated strategy and sustainable mechanisms at EU level for safeguarding the health of travelers and crew of passenger and cargo ships and preventing the cross-border spread of diseases
SHIPSAN ACT JA
Focus on: prevention, identification, assessment & link with existing mechanisms for response coordination to serious cross border threats to health caused by communicable diseases, chemical, biological and radiological agents
Facilitate the implementation of the EU legislation
Facilitate implementation of IHR:
Supporting core capacities by training, inspections, contingency planning guidance and IHR provisions for conveyances and conveyance operators including SSC

6. 32 institutions from 24 EU MS participate

7. EU SHIPSAN ACT JA Deliverables
WP1 - Integrated operations plan for the permanent implementation of JA activities
WP2- Interim and final technical and financial reports
WP3 - Dissemination activities report including exit/sustainability plan and website
WP5 - Interim and final evaluation reports
WP4 - State of the art report
WP6 – Database of the SHIPSAN integrated inspection programme for all types of ships
WP7 - Guidelines for dealing with chemical and radiological incidents on ships, table top exercise and training material
WP8- SHIPSAN ACT information system (SIS)
WP9 - Training material, training activities report and e-earning platform
WP10- Design of a Risk Assessment Tool for occupational hazards and public health risks per cargo ship type

8. Research: State of the Art report (WP4)
Part A
Literature review on infectious diseases on all types of ships
Part B
Literature review and survey on chemical and radiological incidents in maritime transport
Part C
Survey on hygiene inspection practices on fishing vessels in EU
Part D
Survey on training needs related to core capacities at points of entry-ports in EU
Part E
Survey on practices & responsibilities of port health authorities along inland waterways in EU
A five part report will be compiled, consisting of:

9. International Health Regulations Capacities at all times:
To prevent, protect against, control and provide a public health response to the international spread of disease
To avoid unnecessary interference with international traffic and trade
To define the core capacity requirements for designated points of entry (airports, ports and ground crossings) at all times and also for responding to events that may constitute a Public Health Emergency of International Concern (PHEIC)
The purpose and scope of the International Health Regulations (IHR) 2005 are:

10. Objective
To identify training needs related to core capacities under International Health Regulation at ports among European Union countries

11. Methodology
Survey
Standard questionnaire for EU MS + Iceland and Norway.
Training needs related to core capacities at all times
Training needs related to core capacities for responding to a Public Health Emergency of International Concern
The analysis was performed using Epi Info 7
The research took place in the autumn .
The questionnaire was specific for this study. A specific working group was set up to prepare the specific questionnaire, based on the international literature and IHR.
The questionnaire was sent to relevant authorities among all EU Member States ascending countries plus Iceland and Norway.
The data were analysed using Epi Info 7. Not all questions were answered by the authorities. Thus, the percentages were calculated using the number of authorities that answered the specific question as the denominator (excluding the missing values).

12. 20 countries (67%) answered the questionnaire
Results
The questionnaires were sent to all EU MS and ascending countries not only to the countries participating in the Joint Action.
20 countries (67%) answered the questionnaire

13. National policies and practices at ports
The type of competent authority for issuing Ship Sanitation Certificates (SSC) was identified and specified by 85% (17/20) of the countries.
% of type of authority competent for issuing the SSC. N=17
The majority (53%) reported that regional or local authorities are responsible for issuing SSC are
Eight countries (47%) reported that the national authorities are responsible for issuing SSC.

14. National policies and practices at ports
Number of countries according to their policies and practices for issuing Ship Sanitation Certificates (SSC)
Nine countries (43%) indicated that they have prepared national guidelines for issuing SSC and they developed their guidelines based on the WHO Handbook for inspection of ships and issuing SSC.
Furthermore they reported to have a country-wide or a regional database for recording the ships inspection results for issuing the SSC.

15. Human resources at ports
Twenty (all) countries have designated personnel to inspect ships and ports from a sanitary point of view.
Inspections and outbreak management is conducted by different personnel in 74% of the countries (14/19).
All the responding countries, have designated personnel to inspect ships and ports from a sanitary point of view.
Their main qualifications required are university degree in biomedicine, environmental health, health inspectors, sanitary officers or epidemiologists.
However, Inspections and outbreak management is conducted by different personnel in 74% of the countries (14/19).
This means that only five countries reported that the same personnel perform ship and port inspections as well as outbreak management on board ships.

16. Contingency plan
% countries with contingency plans for public health emergencies at designated ports. N=18
With regard to contingency plans, eighteen countries answered to this question.
Twelve countries (67%) reported to have plans for public health emergency at designated ports in line with the IHR-2005 requirements.

17. Training needs related to core capacities at ports
% countries by type of training received by the ship inspector to issue Ship Sanitation Certificates. N=16
Sixteen countries mentioned that the ship inspectors in charge for issuing SSC received specific training.
1. mainly national

18. Training needs related to core capacities at ports
Needs for training at all time
Regarding the needs for training at all times of the personnel working at the ports in the different countries,
1 eleven countries specified an intensive need for training in public health risks from microbiological, chemical and radiological agents.
2. Ten countries expressed an intensive need for training on communication strategy with other competent authorities
nine countries for training in public health measures such as disinfection, decontamination, isolation, quarantine, contact tracing, entry and exit control.
All countries indicated intensive or moderate training needs for knowledge and skills for detecting, reporting, assessing and provide first control measures to public health events

19. Training needs related to core capacities at ports
Countries by type of training and usefulness by staff position
Most of the countries reported that they find useful or very useful that inspectors and managers personnel receive face to face training.
Regarding the e-learning fewer countries found it useful or very useful

20. Training needs related to core capacities at ports
Countries by type of learning activities and preferences by staff position
Overall, countries considered useful or very useful that both inspectors and managers receive all learning activities including presentations and case studies in classroom, e-learning case studies and practical training onboard ship. Practical training onboard ship for inspectors and case studies in classroom for managers were considered trainings useful or very useful by most of the countries

21. Training needs related to core capacities at ports
% countries by type of training received by the inspectors for responding to public health emergencies. N=11
Regarding the needs for training for responding to events that constitute public health emergency of international concern (PHEIC),
It was specified that the inspectors received mainly the WHO training course and other training courses such as general public health training

22. Training needs related to core capacities at ports PHEIC
Sixteen countries completed the question regarding the training needs for responding to a Public Health Emergency of International Concern
The majority mentioned that they have intensive training needs in procedures to report to the competent authority for the point of entry.
Second was mentioned intensive needs for training in quarantine of suspected travellers,
In knowledge of their national legislation and protocols to respond to PHEIC;
Six countries reported that they do not have any need for training for responding to PHEIC in recognizing disease symptoms and in infection control on animals
PHEIC: Public Health Emergency of International Concern

23. Training needs related to core capacities at ports
Countries by type of training and usefulness for personnel implementing contingency plans by staff position
Most of the countries reported that they find useful or very useful that inspectors and managers personnel receive face to face training for implementing contingency plans at ports.
To a lesser extend, E-learning training for inspectors and managers was also considered useful or very useful

24. Training needs related to core capacities at ports
Countries by type of learning activities and preferences for personnel implementing contingency plans by staff position
Overall countries considered useful or very useful that both inspectors and managers receive learning activities
What kind of activities?
presentations and case studies in classroom and practical training onboard ship.

25. CONCLUSIONS

26. Human resources at ports
There is designated personnel for IHR activities but practices are not homogenous.
Collaboration between authorities performing inspections and authorities carrying out outbreak investigation should be encouraged.

27. Specific training requirements
In all topics in line with the International Health Regulations (IHR) requirements at points of entry
They especially indicate an intensive training need related to public health risks from microbiological, chemical and radiological agents
Quarantine of suspected travellers
Proceedings to report to the competent authorities and
Tool-kit to deal with the above
Personnel working at ports

28. Thank you for your attention!