Understanding the Strengths and Limitations of Current Methods for Surveying Partner Nation Medical Facilities
Authors: Regalbuto Eric , Stone Alexandra , Taylor Jessica , Shiau Danny , Wilson Ramey 
Published: September 2023

ABSTRACT

Introduction
During exercises or operations, there may be times when U.S. medical capabilities are not available and the next best or only option may be to use partner nation (PN) or host nation capabilities. Joint Publication 4-02 Joint Health Services states that “medical planners should always consider the quality, suitability, and availability of multinational and host-nation support.” It is normal practice for medical planners to survey PN medical capabilities as part of the pre-deployment planning process. Currently, medical capability surveys are not conducted in a consistent and systematic manner across the DoD global health engagement enterprise. The lack of a systematic approach undermines medical operations planners’ ability to conduct efficient and adequate pre-deployment surveys.

Materials and Methods
The article presents the results of a descriptive analysis of 62 unclassified medical capability surveys of PN or host nation facilities from the U.S. Africa Command (USAFRICOM) area of responsibility that were conducted by U.S. DoD personnel. The team characterized the content and formats of surveys with respect to what medical capabilities were described, how the capabilities were described, and how the information was presented. These analyses focused on determining if a surveyor obtained information about a capability, not whether or not the facility had a capability.

Results
Approximately 75-80% of surveys included information describing the presence or absence of five key capabilities: Emergency department/trauma care, surgical services, intensive care unit, laboratory, and imaging. Conversely, 30-50% of surveys did not include any information describing the presence or absence of five other key capabilities: Pharmacy, blood bank, mass casualty plans, land evacuation, or air evacuation. Information on key capabilities and administrative information was not consistently reported across the sample of surveys. There was substantial variation in how capabilities were characterized, including number of staff, staff training, and available equipment. Additionally, the order in which information was presented in surveys varied within and across components.

Conclusions
There are significant inconsistencies in the types of capabilities and services documented and how the quality of the capabilities and services is characterized. These inconsistencies can be attributed, in part, to the absence of information that explicitly confirmed whether or not the facility had a capability. Such variation results in obscured or incomplete depictions of facility capabilities, thereby undermining the ability of medical planners to coordinate effective medical readiness for engagements, exercises, or real-life operations. Guidance and survey templates could support better-informed decision-making by including information about survey methods and documenting the lack of confirmatory information. The DoD enterprise should consider how guidance and a standard survey template could improve the relevance, accuracy, and efficiency of data collection and reporting.