World Health Organization · Revised edition, 2025 · 50 pages
A systematic framework for national and subnational authorities to harmonize data collection and monitoring of non-pharmaceutical interventions during public health emergencies.
- Issuer
- World Health Organization
- Edition
- Revised edition, 2025
- Audience
- Policy-makers, health authorities, emergency responders, researchers in public health institutes, ministries of health, and academic institutions responsible for emergency preparedness and response
- Evidence
- Expert consensus developed through multistage consultative process with technical experts, stakeholders from all six WHO regions, and review by global public health institutions; based on analysis of COVID-19 PHSM trackers and monitoring frameworks
- Reviewed
- 15 Oct 2026 · GMJ
What this guideline says
GMJ summary
This revised 2025 WHO guidance establishes a standardized framework for monitoring public health and social measures (PHSM)—non-pharmaceutical interventions such as mask mandates, quarantine, school closures, and travel restrictions—during health emergencies. The guidance addresses the fragmentation observed during COVID-19, when different countries and organizations used inconsistent taxonomies and data collection methods, hampering comparability and evidence synthesis.
The document provides a six-step process for establishing a PHSM monitoring system: establishing the monitoring team and mandate, designing data collection methods, categorizing and recording measures using a standardized taxonomy (Annex 3), quality assurance through peer validation, optional quantification into stringency indices, and planning for data analysis and dissemination. The minimum dataset includes the PHSM category, level of enforcement (0=lifted to 4=eliminate options), setting, geographical scope (national/subnational/local), target population, implementation date, measure description, and source documentation.
The guidance emphasizes that PHSM monitoring is integral to the emergency preparedness and response cycle, supporting real-time decision-making during emergencies, enabling research on measure effectiveness, ensuring compliance with International Health Regulations (2005) Article 43 reporting requirements, and facilitating continual learning. Data should be considered alongside epidemiological data, behavioural insights, risk communication, medical countermeasures, social protection policies, and economic indicators for comprehensive emergency response.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Establish a dedicated PHSM monitoring team within government or public health institutes, with clear mandate for data collection, analysis, and reporting to response teams
- Use the standardized PHSM taxonomy with three cascading levels: first-level categories (active case-finding, personal protection, environmental measures, social measures, international travel/trade), second-level categories, and high-level indicators (Annex 3)
- Record minimum critical policy elements for every measure: category, enforcement level (ordinal 0–4 scale), setting (17 defined settings from homes to points of entry), geographical scope (national/subnational/local), target population (general vs. specific groups), implementation date, description, and source with access date
- Classify enforcement stringency using the five-level scale: 0=lifted, 1=inform (provide information), 2=guide (recommend), 3=restrict options (require with limited alternatives, e.g., mask mandate with fine), 4=eliminate options (mandatory with no alternatives, e.g., no mask=no public transport)
- Monitor primary government sources (Ministry of Health, head of state websites, official social media) daily during acute emergency phases, transitioning to weekly/biweekly/monthly as situation stabilizes
- Archive all source webpages using online tools or PDFs at time of data collection to preserve evidence of policy announcements
- Perform quality assurance through three steps: completeness checks of database fields, timeliness review of data entries, and peer validation by exchanging databases among trained team members
- Integrate PHSM monitoring data with epidemiological indicators, vaccination coverage, behavioural data, and social protection measures to inform comprehensive policy decisions during emergency response and recovery phases
Scale for classifying the level of enforcement of public health and social measures
Table extracted from the guideline
| Ordinal scale | Description | Example |
|---|---|---|
| 0: Lifted | A measure has been phased out or removed | Advising that masks are no longer required when taking public transport |
| 1: Inform | Provides information about options regarding specific activities or behaviours | Providing information to the public about the benefits of wearing masks while on public transport |
| 2: Guide | Suggests specific activities or behaviours through recommendations or enabling measures | Providing a recommendation to individuals that they should wear masks while on public transport |
| 3: Restrict options | Restricts options for specific activities or behaviours, thereby strongly promoting or discouraging the activities or behaviours while offering limited alternatives | Requiring individuals to wear masks while on public transport or pay a fine |
| 4: Eliminate options | Eliminates options for specific activities or behaviours (e.g. through prohibition), thereby determining people's activities or behaviours and offering no alternatives | Making it compulsory to wear a mask on public transport; those who are not wearing a mask will not be allowed to take public transport |
Source: World Health Organization, Global guidance on monitoring public health and social measures policies during health emergencies. Reproduced in summary form.
What changed in this edition
Versus the previous edition
- Minor adjustments to selected PHSM categories listed in Annex 3 following reviews conducted in light of the amendments to the International Health Regulations (2005) adopted by the World Health Assembly on 1 June 2024
- Main content of the publication remains unchanged from the original August 2024 version
From the guideline
Verbatim
“PHSM are the first and often the only intervention available at the onset of an outbreak when effective medical countermeasures, such as vaccines and therapeutics, have not been developed or equitably distributed.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As Chair of the Public Health Institute of Georgia and having advised WHO on health emergency preparedness, I recognize this guidance addresses a critical gap we faced during COVID-19 when Georgia's regions implemented inconsistent measures without systematic tracking. The five-level enforcement scale (0=lifted to 4=eliminate options) provides exactly the granularity our NCDC needs to compare Tbilisi's restrictions with Adjara or Imereti and to analyse which combinations reduced transmission. I would stress to Georgian colleagues the importance of archiving all government announcements—our Ministry of Health's COVID-19 webpage was reorganized multiple times, losing historical policy records that would now be invaluable for research. The realistic caveat is capacity: daily monitoring during outbreak onset requires at least two trained staff with strong Georgian and English language skills, and our public health institutes currently lack the stable financing for such dedicated surveillance functions outside donor-funded projects. Georgia should pilot this framework through our existing IHR focal point infrastructure before the next respiratory virus season.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 15 Oct 2026
Applicability
Georgia and the South Caucasus
This guidance is directly applicable to Georgia and the South Caucasus region, where coordination of PHSM policies across national and municipal levels during emergencies has faced challenges. Georgia’s National Center for Disease Control and Public Health (NCDC) could serve as the natural home for the monitoring function described in this guidance, leveraging existing IHR (2005) reporting infrastructure. The framework would support standardized tracking of measures across Tbilisi, Adjara, and other regions, addressing the fragmentation observed during COVID-19 when different municipalities implemented varying restrictions. For countries in Eastern Europe and the Caucasus with limited digital health infrastructure, the guidance’s flexibility to use simple Excel-based databases and manual monitoring during acute phases is particularly relevant. National programmes should consider capacity for daily monitoring during outbreak onset, multilingual source tracking (Georgian, Russian, English), and integration with existing surveillance systems at the NCDC or equivalent public health institutes in Armenia and Azerbaijan.
Questions this guideline answers
Quick answers
What is the minimum frequency for monitoring PHSM policies during an emergency?
During early stages when measures are rapidly changing, daily monitoring may be necessary. As the situation stabilizes, reduce to weekly, biweekly, or monthly based on the recent pace of policy changes. For example, mpox monitoring transitioned from weekly to biweekly to monthly as measures stabilized.
Where should the PHSM monitoring system be established within government?
Ideally within the area responsible for PHSM decision-making (e.g., Ministry of Health or public health institute) to ensure seamless collaboration and information-sharing. Public health institutes may be well-placed if government lacks direct capacity. Academic institutions can be considered as alternatives.
How should measures targeting specific populations be classified?
Use the binary target population field: 0=targeted (specific subpopulation like elderly, children, essential workers, migrants, immunocompromised individuals—list the specific group), 1=general (entire population, or broadly applicable with minor exceptions like mask mandate for everyone except children under 12), or N/A when not applicable.
What is the difference between announcement date and implementation date?
Always record the true implementation date when the policy comes into effect, not the announcement date. Measures are often announced in advance to allow preparation time. Follow up on measures announced far in advance in case they are subsequently cancelled or altered before implementation.
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- Issuer
- World Health Organization
- Type
- Guidance (normative)
- Edition
- Revised edition, 2025
- Replaces
- Original edition published August 2024
- Status
- Current
- Published
- 2025-10-02
- Languages
- English
- Scope
- Global, applicable to all countries and health emergencies (focus on infectious diseases but adaptable to other hazards)
- Audience
- Policy-makers, health authorities, emergency responders, researchers in public health institutes, ministries of health, and academic institutions responsible for emergency preparedness and response
- Pages
- 50
- Licence
- CC BY-NC-SA 3.0 IGO
- ISBN
- 978-92-4-011456-2
- Evidence
- Expert consensus developed through multistage consultative process with technical experts, stakeholders from all six WHO regions, and review by global public health institutions; based on analysis of COVID-19 PHSM trackers and monitoring frameworks
- Next review
- Living document to be updated periodically to reflect evolving PHSM landscape and emerging good practices
- Record history
- Created 15 Oct 2026 · updated 15 Oct 2026 · next check Apr 2027
World Health Organization. Global guidance on monitoring public health and social measures policies during health emergencies: revised edition, 2025. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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