scholarly journals Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Mitsuru Toda ◽  
Dejan Zurovac ◽  
Ian Njeru ◽  
David Kareko ◽  
Matilu Mwau ◽  
...  
Author(s):  
Annastacia Katuvee Muange ◽  
John Kariuki ◽  
James Mwitari

Background: Community based disease surveillance (CBDS) may be defined as an active process of community involvement in identification, reporting, responding to and monitoring diseases and public health events of concern in the community. The scope of CBS is limited to systematic continuous collection of health data on events and diseases guided by simplified lay case definitions and reporting to health facilities for verification, investigation, collation, analysis and response as necessary.Methods: A cross sectional study design, interventions study program was adopted to determine the effectiveness of CBDS in detecting of priority diseases. Purposive and random sampling methods was employed to select the respondents.Results: The results of the study assisted the Ministry of health to understand the effectiveness of Community based surveillance in detection of priority diseases and hence strengthen the community-based surveillance initiative. From the findings, the integrated disease surveillance data for five years from 2014-2018 shows, more cases of priority diseases reported in health facilities linked to a community unit trained on CBDS. Cholera (9/5), Malaria (4757/2789), Neonatal tetanus (27/3) respectively.Conclusions: The study concluded that, use of community-based surveillance system, improves detection of the notifiable diseases in the community. The study revealed that there is a gap on training of community-based disease surveillance system and therefore there is need for continuous refresher trainings on CBDS to the CHVs and CHAs to accommodate also the newly recruited.


2020 ◽  
Author(s):  
Kiros Fenta Ajemu ◽  
Abraham Aregay Desta ◽  
Nega Mamo Bezabih ◽  
Alemnesh Abraha Araya ◽  
Essayas Haregot Hilawi

Abstract Background: The health impacts of recent global infectious disease outbreaks have demonstrated the importance of strengthening public health systems. The aim of the study was to assess the level of quality of integrated disease surveillance and response for infectious disease in public health facilities of Tigray, Northern Ethiopia. Methods: the study was facility based cross-sectional. It was conducted from June- July 2018 in 46 health facilities. It has involved mixed method approach both quantitative and qualitative data collection methods. Donabedian input-process-output quality assessment model was used to evaluate the service. The magnitude of the association was considered at p-value of ≤0.05 in multivariable logistic regression analysis using adjusted odds ratio (AOR) at 95% confidence interval (CI). Concurrently, facility surveillance officers were subjected to an in-depth interview autonomously to explore factors for good and bad service quality. Quantitative data were analyzed using SPSS version 21. Use of manual thematic approach was used for qualitative data analysis. Result: The level of the overall quality of IDSR service provision has rendered as good in 6 out of 46(13%) studied health facilities. Two third of studied health facilities were rated as good for input service quality but 34.7% for process service quality. The output service quality was two times better than the overall service quality. Being enrollment of HIT to rapid response team (AOR=7, 95% CI: 1.092- 37.857) and accessing technical guideline to the health facility (AOR=3, 95% CI: 0.399-22.567) were predictor factors for facilitating overall service quality.


2021 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke

Abstract Background: During 2019, neonatal conditions in Ethiopia accounted for 56% of under-5 deaths, with 33 neonatal deaths occurring for every 1,000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades. Methods: A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities from April to July 2017. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Results: Out of the ten quality of newborn care variables, 8.7 [95%CI: 6.03-11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168-7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152-6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867-5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007-7.325] and rural health centres had a lowest mean score, 2.3 [95%CI: 2.043-2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness score [95%CI: 0.134-0.768]. Conclusion: The quality of newborn care was high at the higher-level health facilities and lower in the lower level health facilities such as rural health centres and health posts; where these facilities are designed to provide the newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions were critically low in rural health centres where these are a referral receiving health facilities from health posts. Thus, the rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.


2021 ◽  
Author(s):  
Sekyere Stephen Owusu ◽  
Laar Salam Dam-Park

AbstractBackgroundMeasles is a disease of public health importance earmarked for elimination by all WHO Regions. Globally, more than 140 000 people died from Measles in 2018 affecting mostly children under 5 years, despite the availability of safe and effective vaccine.MethodsA descriptive cross-sectional survey was conducted. Disease surveillance focal persons were interviewed using semi-structured questionnaire on the system operations and use of Measles case definitions. Measles case-based investigation forms from 2015 – 2020 were reviewed for its timeliness and data quality. CDC updated guidelines for surveillance system evaluation was used to assess its usefulness and attributes. Data was analyzed for frequencies and proportions and results presented in tables and graphs.ResultsMeasles surveillance system was timely as 100% (69/69) of the suspected cases were reported on time. Also, the level of representativeness was good as all the 14 health facilities in the District were participating in the Measles Surveillance system. Majority 73.1 (44/60) of the case-based investigation forms filled were incomplete with some columns wrongly filled.ConclusionDespite the outbreak of Covid – 19 with most districts battling with how to contain the virus, measles surveillance system was still meeting its objectives of early detection and prompt reporting but with poor data quality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatma Saleh ◽  
Jovin Kitau ◽  
Flemming Konradsen ◽  
Leonard E. G. Mboera ◽  
Karin L. Schiøler

Abstract Background Disease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determine its capacity for early detection of and response to infectious disease outbreaks. Methods This cross-sectional descriptive study involved 10 districts of Zanzibar and 45 public and private health facilities. A mixed-methods approach was used to collect data. This included document review, observations and interviews with surveillance personnel using a modified World Health Organization generic questionnaire for assessing national disease surveillance systems. Results The performance of the IDSR system in Zanzibar was suboptimal particularly with respect to early detection of epidemics. Weak laboratory capacity at all levels greatly hampered detection and confirmation of cases and outbreaks. None of the health facilities or laboratories could confirm all priority infectious diseases outlined in the Zanzibar IDSR guidelines. Data reporting was weakest at facility level, while data analysis was inadequate at all levels (facility, district and national). The performance of epidemic preparedness and response was generally unsatisfactory despite availability of rapid response teams and budget lines for epidemics in each district. The support functions (supervision, training, laboratory, communication and coordination, human resources, logistic support) were inadequate particularly at the facility level. Conclusions The IDSR system in Zanzibar is weak and inadequate for early detection and response to infectious disease epidemics. The performance of both core and support functions are hampered by several factors including inadequate human and material resources as well as lack of motivation for IDSR implementation within the healthcare delivery system. In the face of emerging epidemics, strengthening of the IDSR system, including allocation of adequate resources, should be a priority in order to safeguard human health and economic stability across the archipelago of Zanzibar.


Author(s):  
Joseph HK Bonney ◽  
Theodore W Asigbee ◽  
Erasmus Kotey ◽  
Keren Attiku ◽  
Franklin Asiedu-Bekoe ◽  
...  

Background: Viral hemorrhagic fevers (VHFs) are infectious illnesses that can cause serious morbidity and mortality to infected persons. During the 2014 Ebola virus disease outbreak in some West African countries, Ghana revamped its surveillance system across the country to prepare, effectively respond and pre-empt any public health concerns Objective: We report on suspected VHF clinical specimens submitted to the Noguchi Memorial Institute for Medical Research (NMIMR) from health facilities across the country for diagnosis within the period under review. This was partly to provide rapid response and to alert the health system to prevent outbreaks and its spread. Methods: From January 2017 to December 2018 clinical specimens of blood from 149 cases of suspected VHFs were collected at health facilities across the country and sent to NMIMR. Patient specimens were tested for viral pathogens including Lassa fever, Yellow fever, Dengue fever, Chikungunya, Zika, Ebola and Marburg by real-time reverse transcription-polymerase chain reaction. A case was however tested for influenza as the patient exhibited respiratory distress symptoms as well. Demographic and clinical information collected on a structured case-based forms were analyzed for each patient. Results: Out of the 149 clinical specimens tested, three (3) were found to be positive, with two (2) being Dengue and one (1) seasonal Influenza A H1N1. Analysis of the case-based forms revealed shortcomings with regards to standard case definitions used to enroll suspected cases. Conclusion: Our results buttress the need for a routine surveillance activity for VHFs to minimize spread and possibly forestall outbreaks. Moreover, febrile illnesses can be caused by a host of pathogens hence there is a need for enhanced diagnosis to help in patient management.


2021 ◽  
Vol 2 ◽  
Author(s):  
Ai Aoki ◽  
Keiji Mochida ◽  
Michiru Kuramata ◽  
Toru Sadamori ◽  
Helga Reis Freitas ◽  
...  

Background: Reducing maternal, neonatal, and infant mortality tops the health targets of sustainable development goals. Many lifesaving interventions are being introduced in antenatal, delivery, and postnatal care. However, many low- and middle-income countries (LMICs) have not reached maternal and child health targets. The Maternal and Child Health Handbook (MCH-HB) is recommended as a home-based record to promote a continuum of care from pregnancy to early childhood, and is gaining increasing attention among LMICs. Several countries have adopted it as national health policy. To effectively utilize the MCH-HB in LMICs, implementation needs to be considered. Angola is an LIMC in Sub-Saharan Africa, where maternal and child health indicators are among the poorest. The Angolan Ministry of Health adopted the MCH-HB program in its national health policy and is currently conducting a cluster randomized controlled trial (MCH-HB RCT) to evaluate its impact on the continuum of care. This study aimed to evaluate implementation status, and barriers and facilitators of MCH-HB program implementation in Angola.Methods: To evaluate implementation status comprehensively, the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework will be used. Four components other than effectiveness will be investigated. A cross-sectional survey will be conducted targeting all health facilities and officers in charge of the MCH-HB at the municipality health office in the intervention group after the MCH-HB RCT. Data from the cross-sectional survey, secondary MCH-HB RCT data, and operational MCH-HB RCT records will be analyzed. Health facilities will be classified into good-implementation and poor-implementation groups using RE-AIM indicators. To identify barriers to and facilitators of MCH-HB implementation, semi-structured interviews/focus group discussions will be conducted among health workers at a sub-sample of health facilities and all municipality health officers in charge of MCH-HB in the intervention group. The Consolidated Framework for Implementation Research will be adopted to develop interview items. Thematic analysis will be performed. By comparing good-implementation and poor-implementation health facilities, factors that differ between groups that contribute to successful implementation can be identified.Discussion: This study's findings are expected to inform MCH-HB implementation policy and guidelines in Angola and in other countries that plan to adopt the MCH-HB program.


BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022817 ◽  
Author(s):  
Tuhin Biswas ◽  
M Moinuddin Haider ◽  
Rajat Das Gupta ◽  
Jasim Uddin

ObjectiveThe objective of this study was to assess the readiness of health facilities for diabetes and cardiovascular services in Bangladesh.DesignThis study was a cross-sectional survey.SettingThis study used data from a nationwide Bangladesh Health Facility Survey conducted by the Ministry of Health and Social Welfare in 2014.ParticipantsA total of 319 health facilities delivering services focused on diabetes and cardiovascular diseases (CVD) were included in the survey. Some of these facilities were run by the public sector while others were managed by the private sector and non-governmental organisations. It was a mix of primary and secondary care facilities.Primary and secondary outcome measuresThe primary outcome was readiness of health facilities for diabetes and cardiovascular services. We analysed relevant data following the Service Availability and Readiness Assessment manual of the WHO to assess the readiness of selected health facilities towards services for diabetes and CVD.Results58% and 24.1% of the facilities had diagnosis and treatment services for diabetes and CVD, respectively. Shortage of trained staff (18.8% and 14.7%) and lack of adequate medicine supply (23.5% and 43.9%) were identified to be factors responsible for inadequate services for diabetes and CVD. Among the facilities that offer services for diabetes and CVD, only 0.4% and 0.9% had all the four service readiness factors (guideline, trained staff, equipment and medicine).ConclusionsThe study suggests that health facilities suffered from numerous drawbacks, such as shortage of trained staff and required medicine. Most importantly, they lack effective guidelines on the diagnosis and treatment for diabetes and CVD. It is, therefore, essential now to ensure that there are trained staff, adequate medicine supply, and appropriate guidelines on the diagnosis and treatment for diabetes and CVD in Bangladesh.


2017 ◽  
Vol 158 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Karthik Balakrishnan ◽  
Ellis M. Arjmand ◽  
Brian Nussenbaum ◽  
Carl Snyderman

Objective The objective is to describe variations in the otolaryngology morbidity and mortality (M&M) conference and to compare with other specialties. Design Cross-sectional survey. Setting The setting included otolaryngology departments across the United States and nonotolaryngology medical and surgical departments at 4 academic medical centers. Subjects and Methods Participants were members of a national otolaryngology quality/safety network and nonotolaryngology quality leaders at 4 large academic hospitals. Surveys were administered January 2017. Respondents described M&M conference practices, goals, and educational role. Results Twenty-eight of 39 individuals representing 28 institutions completed the otolaryngology survey (72% response rate). Of 197 individuals, 60 (30% response rate) representing 11 surgical and 20 nonsurgical specialties completed the comparison survey. Twenty-seven of 28 otolaryngologists (46 of 60 nonotolaryngologists) worked in academic settings. All otolaryngology programs conducted an M&M conference: 54% discussed all adverse events and errors; 32% used standard case selection processes; 70% used structured discussion, usually root cause analysis (64%); and 32% classified harm level. In comparison with other specialties, otolaryngology programs were more likely to discuss all adverse events and errors ( P = .01). Most conferences led to quality projects and intrainstitutional communication: 22% communicated to patients and families; 73% of respondents thought that M&M conferences should be standardized or use “best practices.” In both surveys, improving patient care was rated the conference’s most important function, followed by trainee education and culture change. Patient care and practice-based learning were rated the most relevant Accreditation Council for Graduate Medical Education Core Competencies in both surveys. Conclusions Academic otolaryngology M&M practices generally align with other specialties, but specifics vary widely, making collaborative quality improvement challenging. Educational and administrative priorities cross specialties. Most respondents thought that standardization and best practices are worthwhile. Nonacademic practice data are needed.


Sign in / Sign up

Export Citation Format

Share Document