[Intra- and after-action reviews of public health emergencies: report of the Brazilian experience and achievements, 2023 to 2025Evaluación durante y después de una emergencia de salud pública: experiencia y avances de Brasil entre el 2023 y el 2025]

[突发公共卫生事件的行动中和行动后审查:2023年至2025年巴西经验和成就报告Evaluación durante y después de una emerncia de salud pública:experiencia y avances de Brasil entre el 2023 y el 2025]

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Abstract

Intra and after action reviews (IARs and AARs) are essential for the management of public health emergencies. This article reports on the experience of developing an IAR and AAR method by the Ministry of Health in Brazil, highlighting its conceptual and organizational foundations and its application in different public health emergency contexts from 2023 to 2025, a period during which 10 evaluations were conducted nationwide. The method was developed through a participatory process, based on a literature review and consultations with national and international experts, and was validated by consensus. The reviews were carried out in partnership with state health departments, using methodologies such as in-person workshops, structured debriefings, response action assessment tools, and individual instruments, often in combination. The number of participants ranged from 40 to 80 professionals, including managers, technical staff, and representatives from multiple sectors. The duration of activities ranged from meetings lasting a few hours to 2-day workshops. The reviews revealed good practices, challenges, and next steps that informed the updating of contingency plans and the incorporation of lessons learned into national and subnational policies and guidelines, synthesized in a Guide for After Action Review of Public Health Emergencies published by the Ministry of Health. This experience underscores the importance of incorporating IARs and AARs as strategic components of public health emergency preparedness and response. The process strengthens organizational learning, enhances the legitimacy of actions, and contributes to building a culture of continuous monitoring.

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