scholarly journals Evaluation of Measles Surveillance Systems in Ginnir District, Bale Zone, Southeast Ethiopia: A Concurrent Embedded Mixed Quantitative/Qualitative Study 

Author(s):  
Falaho Sani ◽  
Mohammed Hasen ◽  
Mohammed Seid ◽  
Nuriya Umer

Abstract Background: Public health surveillance systems should be evaluated periodically to ensure that the problems of public health importance are being monitored efficiently and effectively. Despite the widespread measles outbreak in Ginnir district of Bale zone in 2019, evaluation of measles surveillance system has not been conducted. Therefore, we evaluated the performance of measles surveillance system and its key attributes in Ginnir district, Southeast Ethiopia.Methods: We conducted a concurrent embedded mixed quantitative/qualitative study in August 2019 among 15 health facilities/study units in Ginnir district. Health facilities are selected using lottery method. The qualitative study involved purposively selected 15 key informants. Data were collected using semi-structured questionnaire adapted from Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems through face-to-face interview and record review. The quantitative findings were analyzed using Microsoft Excel 2016 and summarized by frequency and proportion. The qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings.Results: The structure of surveillance data flow was from the community to the respective upper level. Emergency preparedness and response plan was available only at the district level. Completeness of weekly report was 95%, while timeliness was 87%. No regular analysis and interpretations of surveillance data, and the supportive supervision and feedback system was weak. The participation and willingness of surveillance stakeholders in implementation of the system was good. The surveillance system was found to be useful, easy to implement, representative and can accommodate and adapt to changing conditions. Report documentation and quality of data was poor at lower level health facilities. Stability of the system has been challenged by shortage of budget and logistics, staff turnover and lack of update trainings.Conclusions: The surveillance system was acceptable, useful, simple, flexible and representative. Data quality, timeliness and stability of the system were attributes that require improvement. The overall performance of measles surveillance system in the district was poor. Hence, regular analysis of data, preparation and dissemination of epidemiological bulletin, capacity building and regular supervision and feedback are recommended to enhance performance of the system.

2021 ◽  
Author(s):  
Alex Riolexus Ario ◽  
Emily Atuheire Barigye ◽  
Innocent Harbert Nkonwa ◽  
Jimmy Ogwal ◽  
Denis Nixon Opio ◽  
...  

Abstract BackgroundCivil wars in the Great Lakes region resulted in massive displacement of people to neighboring countries including Uganda, with associated humanitarian emergencies. Appropriate disease surveillance enables timely detection and response to outbreaks. We describe evaluation of the public health surveillance system in refugee settlements in Uganda and document lessons learnt.MethodsWe conducted a cross-sectional survey using the US CDC Updated Guidelines for Evaluating Public Health Surveillance Systems in four refugee settlements in Uganda i.e., Bidibidi, Adjumani, Kiryandongo and Rhino Camp. Using semi-structured questionnaires, key informant and focus group discussion guides, we interviewed health facility in-charges, key personnel and village health teams from 4 districts, 53 health facilities and 112 villages.ResultsAll health facilities assessed had key surveillance staff; 60% were trained on IDSR and most village health teams were trained on disease surveillance. Case detection was at 55%; facilities lacked standard case definitions (SCDs) and were using parallel Implementing Partner (IP) driven reporting system. Recording was at 79% and reporting was at 81%. Data analysis and interpretation was at 49%. Confirmation of outbreaks and events was at 76%. Preparedness was at 72% and response was at 34%. Feedback was at 82%. Recording, reporting, preparedness, feedback and confirmation of outbreaks and events were highly achieved, and capacity to evaluate and improve the system was moderately achieved. There were low scores in capacity to detect, respond and analyse data.ConclusionPublic health surveillance system had high sensitivity, timeliness and predictive value positive. It was simple, acceptable with fair data quality attributes. It was less flexible, less stable with low representativeness. The system had good recording, reporting, preparedness, feedback and confirmation of outbreaks and events. The capacity for detection, response and data analysis and interpretation was low. Lessons learnt were: IPs offer tremendous support to surveillance; training of surveillance staff on IDSR maintains effective surveillance functions; supplies of tools, personnel etc. should be planned and executed; functionalization of district teams ensures achievement of surveillance functions and attributes; regular support supervision of health facilities necessary; harmonization of reporting improves surveillance functions and attributes; appropriation of funds to districts to support refugee settlements is complementary.


2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Rhonda A. Lizewski ◽  
Howard Burkom ◽  
Joseph Lombardo ◽  
Christopher Cuellar ◽  
Yevgeniy Elbert ◽  
...  

While other surveillance systems may only use death and admissions as severity indicators, these serious events may overshadow the more subtle severity signals based on appointment type, disposition from an outpatient setting, and whether that patient had to return for care if they their condition has not improved.  This abstract discusses how these additional data fields were utilized in a fusion model to improve the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE).


2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  

Abstract Background: Infectious diseases remain one of the greatest threats to public health globally. Effective public health surveillance systems are therefore needed to provide timely and accurate information for early detection and response. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The completeness of reporting increased significantly after the training by 17 percentage points (from 45% to 62%) for the intervention group compared to 3 percentage points (49% to 52%) for the comparison group. Timeliness of reporting increased significantly by 21 percentage points (from 30% to 51%) for the intervention group compared to 7 percentage points (from 31% to 38%) for the comparison group. Major challenges identified for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers being given other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.


2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  

Abstract Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45% to 62%, i.e. by 17 percentage points (95% CI 16.14 - 17.86) compared to an increase from 49% to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23-3.77). The timeliness of reporting increased from 30% to 51%, i.e. by 21 percentage points (95% CI 20.16 - 21.84) for the intervention group, compared to an increase from 31% to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.


2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  

Abstract Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45% to 62%, i.e. by 17 percentage points (95% CI 16.14 -17.86) compared to an increase from 49% to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23 -3.77). The timeliness of reporting increased from 30% to 51%, i.e. by 21 percentage points (95% CI 20.16 - 21.84) for the intervention group, compared to an increase from 31% to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.


Author(s):  
Richard Hopkins ◽  
Aaron Kite-Powell

Public health surveillance is ‘the ongoing, systematic collection, analysis, interpretation, and dissemination of data about a health-related event for use in public health action to reduce morbidity and mortality and to improve health. Data disseminated by a public health surveillance system can be used for immediate public health action, program planning and evaluation, and formulating research hypotheses. This chapter discusses purposes for surveillance, surveillance opportunities, surveillance system design, public health informatics, evaluating a surveillance system, and general principles for effective surveillance systems.


2019 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  

Abstract Background Infectious diseases remain one of the greatest threats to public health globally. Effective public health surveillance systems are therefore needed to provide timely and accurate information for early detection and response. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2(DHIS2). As part of Global Health Security Agenda(GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates.Methods From February to May 2017, we analysed surveillance data for 13 intervention and 13 control counties. An intervention county was defined as one that had received a refresher training on DHIS2 while a control county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. A Likert scale was used to grade the challenges.Results The completeness of reporting increased after the training by 17 percentage points (from 45% to 62%) for the intervention group compared to 3 percentage points (49% to 52%) for the control group. Timeliness of reporting increased by 21 percentage points (from 30% to 51%) for the intervention group compared to 7 percentage points (from 31% to 38%) for the control group. Major challenges identified for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers being given other competing tasks.Conclusions Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.


2006 ◽  
Vol 11 (11) ◽  
pp. 7-8 ◽  
Author(s):  
G Krause ◽  
J Benzler ◽  
G Reiprich ◽  
R Görgen

Surveillance systems for infectious diseases build the basis for effective public health measures in the prevention and control of infectious diseases. Assessing and improving the quality of such national surveillance systems is a challenge, as many different administrations and professions contribute to a complex system in which sensitive information must be exchanged in a reliable and timely fashion. We conducted a multidisciplinary quality circle on the national public health surveillance system in Germany which included clinicians, laboratory physicians, and staff from local and state health departments as well as from the Robert Koch-Institut. The recommendations resulting from the quality circle included proposals to change the federal law for the control of infectious diseases as well as practical activities such as the change of notification forms and the mailing of faxed information letters to clinicians. A number of recommendations have since been implemented, and some have resulted in measurable improvements. This demonstrates that the applied method of quality circle is a useful tool to improve the quality of national public health surveillance systems.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tefera Alemu ◽  
Hordofa Gutema ◽  
Seid Legesse ◽  
Tadesse Nigussie ◽  
Yirga Yenew ◽  
...  

Abstract Background Evaluation of a surveillance system should be conducted on regular bases to ensure that the system is working as envisioned or not. Therefore, we evaluated Dangila district’s public health surveillance system performance in line with its objectives. Methods In August 2017, a concurrent embedded mixed quantitative/qualitative, facility-based cross-sectional study was conducted in Dangila district among 12 health facilities/sites. The qualitative part involved 12 purposively selected key stakeholders interview. A semi-structured questionnaire adapted from updated CDC guideline for evaluating public health surveillance system was used for data collection through face to face interview and record review. The major qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings. The quantitative findings were analyzed using Microsoft Excel 2007. Results All necessary surveillance guidelines, registers and reporting formats were distributed adequately to health facilities. Only the district health office has Emergency Preparedness and Response Plan (EPRP), but not supported by the budget required to respond in case an emergency occurred. There were no regular data analysis and interpretations in terms of time, place and person. Weekly report completeness and timeliness were 100 and 94.6% respectively. The information collected was considered relevant by its users to detect outbreaks early with high acceptability. All stakeholders agreed that the system is simple, easy to understand, representative and can accommodate modifications. Written feedbacks were not obtained in all health facilities. The supervision checklist obtained in the district was not adequate to assess surveillance activities in detail. The calculated positive predictive value for malaria was 11%. Conclusions The surveillance system was simple, useful, flexible, acceptable and representative. Report completeness and timelines were above the national and international targets. However, the overall implementation of the system in the district was not satisfactory to achieve the intended objective of surveillance for public health action due to the lack of regular data analysis and feedback dissemination. To create a well-performing surveillance system, regular supervision and epidemiologically analyzed and interpreted feedback system is mandatory.


2021 ◽  
pp. 93-109
Author(s):  
Clarissa D. Simon ◽  
Craig F. Garfield

AbstractIncluding the voice of the father in research related to fathering is essential. This chapter describes efforts to establish a new public health surveillance for fathers in the United States. The ultimate goal of this research is to study fatherhood to support healthy child development by collecting valuable information on father health and experiences in the perinatal period. Understanding fathers is key to learning about and improving family health, since fathers impact mothers and babies’ health. Studying the health of fathers during the transition to fatherhood can also provide a window into the overall health status of men, expanding the field of public health to include more specifics on the health of fathers and their impact on families. Currently surveillance systems are lacking in including the fathers’ perspective in measurement of paternal health and the transition to fatherhood. To address these issues we utilized a multi-pronged approach to inform development of a public health surveillance system for fathers: (1) review of the current literature to identify gaps in knowledge on the role of fatherhood in male and family health and identify current national-level surveillance data on fathers; (2) assessed feasibility of identifying participants to implement a surveillance system for fathers; (3) conducted formative research to develop methodology; and (4) piloted a public health surveillance system called the Pregnancy Risk Assessment Monitoring System for Dads or “PRAMS for Dads.”


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