scholarly journals Advancing GHSA: Lessons learned about strengthening HIS and disease surveillance

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Pia D. MacDonald ◽  
Niamh Darcy ◽  
Rita Sembajwe ◽  
Eileen Reynolds ◽  
Henry Chidawanyika ◽  
...  
Keyword(s):  
Information System ◽  
Health Information ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Information System ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Roll Out

ObjectiveThe objective is to discuss two decades of international experiencein health information and disease surveillance systems strengtheningand synthesize lessons learned as applicable to implementation of theGlobal Health Security Agenda (GHSA).IntroductionRTI International has worked on enhancing health informationand disease surveillance systems in many countries, includingThe Democratic Republic of the Congo (DRC), Guinea, Indonesia,Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.Strengthening these systems is critical for all three of the Prevent,Detect and Respond domains within the Global Health SecurityAgenda.We have deep experience in this area, ranging from implementingDistrict Health Information Software (DHIS), electronic medicalrecords, health facility registries, eHealth national strategies,electronic Integrated Disease Surveillance and Response system(eIDSR), mobile real-time malaria surveillance and response, nationalweekly disease surveillance, patient referral system, and communitybased surveillance. These experiences and lessons learned can informwork being done to advance the GHSA.We will discuss several examples, including activities in Zimbabweand Tanzania. RTI has been working in Zimbabwe for over six yearsto strengthen the national health information system. This workhas included the configuration and roll-out of DHIS 2, the nationalelectronic health information system. In doing so, RTI examinedand revitalized the weekly disease surveillance system, improvingdisease reporting timeliness and completeness from 40% to 90%.Additionally, RTI has integrated mobile technology to help morerapidly communicate laboratory test results, a laboratory informationmanagement systems to manage and guide test sample processing,and various other patient level systems in support of health servicedelivery at the local level. This work has involved capacity buildingwithin the ministry of health to allow for sustainable support of healthinformation systems practices and technology and improvements todata dissemination and use practices.Similarly, RTI has worked for more than five years to helpstrengthening the National HIS in Tanzania. These activities haveincluded stakeholder coordination, developing national eHealthstrategy and enterprise architecture, harmonizing indicators,redesigning routine reporting instruments, national DHIS 2 roll-out,information technology infrastructure management and user helpdesk support, reducing the number of parallel information systems,data dissemination and use, development of district health profiles,development of the national health facility registry, and supportingroll-out of the electronic integrated disease surveillance system.MethodsWe will profile selected projects and synthesize critical lessonslearned that pertain to implementation of the GHSA in resourceconstrained countries.ResultsWe will summarize our experience and lessons learned withhealth information and disease surveillance systems strengthening.Topics such as those that relate to advancing the GHSA RealTime Surveillance and Reporting Action Package areas will bediscussed, including: indicator and event based surveillance systems;interoperable, interconnected, electronic real-time reporting system;analysis of surveillance data; syndromic surveillance systems;systems for efficient reporting to WHO, FAO and OIE; and reportingnetwork and protocols in country.ConclusionsOur experience working over the past 14 years in 9 countrieson different HIS and disease surveillance system strengtheningprojects has led to a deep understanding of the challenges aroundimplementation of these systems in limited resource settings. Theseexperiences and lessons learned can inform initiatives and programsto advance the GHSA.

scholarly journals Streamlining Disease Surveillance System implementation in Tanzania: Lessons Learnt

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Green Sadru
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Polio Eradication ◽  
Surveillance Systems ◽  
Health Security ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Different Levels ◽  
Disease Specific ◽  
Global Health Security Agenda

ObjectiveTo support streamlining of VPD surveillance into integrated diseases surveillance and response (IDSR) system in TanzaniaIntroductionTanzania adopted IDSR as the platform for all disease surveillance activities. Today, Tanzania’s IDSR guidelines include surveillance and response protocols for 34 diseases and conditions of public health importance, outlining in detail necessary recording and reporting procedures and activities to be taken at all levels. A total of 15 disease-specific programs/sections in the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) are linked to the IDSR, though the extent to which each program uses IDSR data varies. Over the years, IDSR procedures and the structures that support them have received significant government and external resources to maintain and strengthen detection, notification, reporting and analysis of surveillance information. However, with the imminent phasing out of programs (such as the Polio eradication program) that have supported IDSR strengthening and maintenance in the past, resources for surveillance will become more limited and the government will need to identify additional resources to sustain the country’s essential surveillance functions.Maternal and Child Survival Program (MCSP), a USAID Funded Program supported MOHCDGEC managing active and passive surveillance systems in improving coordination and strengthen the system taking into consideration declining resources as well as transitioning to polio end game where most of the financial resources were derived from to support vaccine preventable diseases surveillance. The support complements other Global health security agenda (GHSA) on the key thematic areas (Prevent, Detect and Report) support to the MOHCDGEC and working with the newly formed Emergency Operations Center (EOC) to improve response.MethodsBetween February and November 2018, the MOHCDGEC and MCSP undertook activities to generate information for future plans to strengthen Tanzania’s disease surveillance system to address the Global Health Security Agenda (GHSA): 1) desk review of country’s disease surveillance 2) meetings with stakeholders involved in surveillance; 3) workshop where stakeholders discussed and developed strategies for streamlining disease surveillance; 4) asset mapping to identify assets (human, financial, physical 5) stakeholders meeting to further discuss and agree on future strategies, activities.ResultsThe Disease surveillance system review found the functions for surveillance being implemented at different levels (Figure 1). These include identifying cases; reporting suspected cases, conditions, or events; investigating and confirming suspected cases, outbreaks and events. To facilitate decision making at different levels, it was found that analysing and response are done at all levels. A total of 15 disease-specific programs/sections in the MOHCDGEC are linked to the IDSR, though the extent to which each program uses IDSR data varies.Key strengths and opportunitiesThe government’s adoption of the IDSR platform and the fact that the MOHCDGEC has a dedicated department to monitor IDSR performance has been a great achievement of the program. The system is fully adaptable to support all disease surveillance with clear supervisory structures in place at regional and council levels. At the operational level there is presence of full-time, competent and dedicated government employees and exhibiting awareness of their responsibilities, and resourcefulness. The entire surveillance program benefits from government and external funding for disease-specific surveillance-related programs (e.g. funds for polio eradication and malaria program).Despite the achievements, there are notable challenges faced by the program including disease-specific programs often requiring additional information and opting to set up parallel surveillance systems rather than integrating with the IDSR; surveillance activities often not being considered high priority at council level relative to curative service and/or surveillance not being a line item in budgets; electronic data transmission platforms not being able to support transmission of all e-IDSR data with the result that health facility data (including diseases for immediate notification) may not get reported in weekly transmissions; high turnover of surveillance staff and unsystematic orientation of newly-deployed staff; discrepancies in reported HMIS, IDSR, and disease-specific program data indicating data quality issues.Asset mapping: At the time of the review, the number of staff available varied widely between programs, with the national laboratory and the National AIDS Control program (NACP) reporting the highest number at council level and Immunization and Vaccine Development (IVD) having significant number of persons supporting vaccine preventable disease surveillance. At the time of the review, most of the funds were allocated in capacity building through training and supportive supervision compared to core surveillance function.Key inteventions to streamlining and harmonizing of surveillance Supported the roll out of electronic IDSR to ensure real time surveillance through DHIS2Supported proceedures to establishement of surveillance expert working group (EWG);Development of Term of reference for EWG to guide implementation of IDSR activitiesDevelopment of transition plan highlighting key stakeholders and the support they provide to strengthening surveillance in the country;Development of workplan to guide implementation of agreed recommendations which includes;1. Coordinating activities of all stakeholders involved in surveillance,2. Developing or advocating for an interoperable and harmonized reporting system through DHIS2 that will accommodate the needs ofthe various disease- and event-surveillance programs,3. Promoting synergies at national level so that active surveillance is expanded as appropriate to other diseases and supports casebased surveillance,4. Building capacity of RHMTs/CHMTs in leadership and management to manage human and financial resources and prioritizesurveillance;5. Coordinating and strengthening disease and event-surveillance at community level by having at least one trained focal person at thecommunity for all disease surveillance.ConclusionsStreamlining and strengthening of the surveillance system could be achieved by existing coordination structures within MOHCDGEC. Strengthening IDSR by implementing an interoperable of reporting systems including integration of laboratory data will achieve harmonization, consistency in data and appropriate response. At the Regional and council level, priority activities identified include strengthening coordination, orientation and training for financial and human resources management for surveillance aimed at strengthening surveillance and response teams. The IDSR should strengthen active surveillance to adopt case based surveillance as deemed appropriate for more diseases. A proposed plan for implementing key activities to achieve integration and streamlining of disease surveillance has been developed and it is hoped that resources will be made available for immediate implementation. 

scholarly journals Australian National Enterovirus Reference Laboratory annual report, 2017

2020 ◽  
Vol 44 ◽  
Author(s):  
Jason A Roberts ◽  
Linda K Hobday ◽  
Aishah Ibrahim ◽  
Bruce R Thorley
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Performance Criterion ◽  
World Health ◽  
Reference Laboratory ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Enterovirus A71 ◽  
Clinical Surveillance ◽  
Health Organization

Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2017, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.33 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Three non-polio enteroviruses, coxsackievirus B1, echovirus 11 and enterovirus A71, were identified from clinical specimens collected from AFP cases. Australia established enterovirus and environmental surveillance systems to complement the clinical system focussed on children and an ambiguous vaccine-derived poliovirus type 2 was isolated from sewage in Melbourne. In 2017, 22 cases of wild polio were reported with three countries remaining endemic: Afghanistan, Nigeria and Pakistan.

Evaluating Chronic Disease Surveillance Systems: Lessons Learned From Applying a Framework to Assess the Alaska Behavioral Risk Factor Surveillance System

2020 ◽  
Vol 41 (3) ◽  
pp. 420-431
Author(s):  
Katie Cueva ◽  
Andrea Fenaughty ◽  
Jessica Aulasa Liendo ◽  
Samantha Hyde-Rolland
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Lessons Learned ◽  
Behavioral Risk ◽  
Surveillance Systems ◽  
Behavioral Risk Factor ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance

Chronic diseases with behavioral risk factors are now the leading causes of death in the United States. A national Behavioral Risk Factor Surveillance System (BRFSS) monitors those risk factors; however, there is a need for national and state evaluations of chronic disease surveillance systems. The Department of Health and Human Services/Centers for Disease Control and Prevention (CDC) has developed a framework on evaluating noncommunicable disease–related surveillance systems; however, no implementation of this framework has yet been published. This article describes the process of, and offers lessons learned from, implementing the evaluation framework to assess the Alaska BRFSS. This implementation evaluation may inform assessments of other state and regional chronic disease surveillance systems and offers insight on the positive potential to consult key stakeholders to guide evaluation priorities.

scholarly journals Converting the existing disease surveillance from a paper-based to an electronic-based system using District Health Information System (DHIS-2) for real-time information: The Lebanese experience

2021 ◽  
Author(s):  
dalal Ali youssef
Keyword(s):  
Real Time ◽  
Disease Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Medical Centers ◽  
Before And After ◽  
Reported Data ◽  
Real Time Information ◽  
Time Information ◽  
Roll Out

Abstract Introduction:The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response.Objectives:This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities. MethodologyThis is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. Challenges and lessons learned during the roll-out process are listed.ResultsFor laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25% to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74% to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity and limited workforce and frequent changes to DHIS-2 versions.ConclusionImplementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.

scholarly journals Disease Surveillance by Private Health Providers in Nigeria: A Research Proposal

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Olusesan A. Makinde ◽  
Clifford O. Odimegwu
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
International Health ◽  
Healthcare Services ◽  
Health Providers ◽  
Factors Affecting ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
The Impact ◽  
Suspicious Case

A large proportion of Nigerians access healthcare services in private health facilities (PHFs) but the compliance of these PHFs to the mandatory disease surveillance and reporting - a means of implementing the international health regulation of 1969 - has not been established. The recent Ebola outbreak spread to Nigeria and revealed challenges in the efficiency of the surveillance system after a suspicious case presented at a PHF. The impact of an inefficient disease surveillance system can be far reaching. Thus, we propose a study to investigate and understand factors affecting compliance of these PHFs to the country disease surveillance and response system.

scholarly journals Enhancing the routine health information system in rural southern Tanzania: successes, challenges and lessons learned

2011 ◽  
Vol 16 (6) ◽  
pp. 721-730 ◽  
Author(s):  
W. Maokola ◽  
B. A. Willey ◽  
K. Shirima ◽  
M. Chemba ◽  
J. R. M. Armstrong Schellenberg ◽  
...  
Keyword(s):  
Information System ◽  
Health Information ◽  
Health Information System ◽  
Lessons Learned

scholarly journals Verification of Neonatal Tetanus Surveillance Systems in Katsina State, Nigeria

2017 ◽  
Vol 4 ◽  
pp. 233339281772958
Author(s):  
Shafique Sani Nass ◽  
Hadi Danawi ◽  
Loretta Cain ◽  
Monoj Sharma
Keyword(s):  
Mortality Rate ◽  
Active Surveillance ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Mortality Rates ◽  
Neonatal Tetanus ◽  
Surveillance Systems ◽  
Surveillance And Response ◽  
Incidence And Mortality ◽  
Record Review

Background: The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. The goal of the study was to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina State, Nigeria. Methods: The study is a retrospective record review using extracted data from NNT records and analyzed using descriptive statistics. Results: The prevalence of NNT and mortality rate were 336 cases and 3.4 deaths per 100 000 population, respectively, whereas the prevalence of NNT and mortality rate reported through the Integrated Disease Surveillance and Response (IDSR) system were 111 cases and 1.0 death per 100 000 population, respectively. Conclusion: The study shows underreporting of NNT in the existing IDSR system. Implications: Active surveillance is a good strategy for verifying underreporting of NNT in the surveillance system. The IDSR system should be strengthened with the capacity to detect events associated with a disease toward global elimination.

scholarly journals Evaluation of the Kano State Lassa Fever Surveillance System, 2015-2018 – Nigeria

2021 ◽  
Author(s):  
Usman yahya Umar ◽  
Mikha'il Abdu Abubakar ◽  
Imam Wada Bello ◽  
Muhammad Shakir Balogun ◽  
Sadiq Tahir ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Case Fatality ◽  
Lassa Fever ◽  
Cross Sectional Study ◽  
Surveillance Systems ◽  
Cross Sectional ◽  
Surveillance And Response ◽  
Male Preponderance ◽  
Training And Support

Abstract BackgroundLassa fever (LF) is one of the priority diseases under surveillance through the integrated disease surveillance and response system (IDSR). We evaluated the LF surveillance system against its set objectives and assessed its attributes. MethodsWe used cross-sectional study design. Forty-seven stakeholders involved in the surveillance system were interviewed using the Centers for Disease Control and Prevention’s Updated Guidelines for Evaluating Public Health Surveillance Systems. The LF surveillance data from January 2015 to December 2018 were also analyzed. The attribute and objectives of the system were evaluated. ResultsOut of the 76 suspected cases recorded in kano state during the study period, only 54 samples were laboratory tested, 11 of them were confirmed positive with 9 deaths (case fatality rate of 82%). Confirmed cases were predominantly in Tudun Wada LGA (63.6%), while the age-group 20-39 years constituted 55% of the confirmed cases. There was male preponderance of cases (73%). The predictive value positive (PVP) was 14.5%. The surveillance system was however meeting its objectives of determining LF burden and detecting and characterizing cases and outbreak.ConclusionLF surveillance system in Kano was simple, flexible, stable, acceptable and timely. However, data was not representative. We recommended improved reporting from private and tertiary facilities and more personnel training and support to improve the system.

scholarly journals Lessons Learned from Introducing a Village Health Registry in Malawi

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Prestor J Kubalalika
Keyword(s):  
Information System ◽  
Community Health ◽  
Health Information ◽  
Health Information System ◽  
Lessons Learned ◽  
Growth Monitoring ◽  
Full Potential ◽  
Ministry Of Health ◽  
Health Registry ◽  
Village Health

The Village Health Registry (VHR) was a community health data collection tool introduced in 1998. It was first introduced in Mwanza district of Malawi with the objectives of collecting community-based data, analysing and taking action in a local setting. The tool was collecting and updating data such as demography, immunization status for children under one year, growth monitoring for children under five, monitoring of all pregnant women, incidence of malaria, acute respiratory infections, diarrhoea cases, water and sanitation and deaths, by visiting households in every village every month.The tool was able to collect all targeted information as required. The data collected by the tool appeared to be more reliable than that obtained through a national information system used by the Ministry of Health (MoH) for the same district and the same year.  It was easy for health centres to accurately order supplies based on actual requirements, to follow-up cases during disease outbreaks and to identify deficiencies in immunisation coverage rates.Despite promising results, the VHR registry fell into disuse following the establishment of a national register.  The MoH’s Health Information System (HIS) data used projections which normally did not represent the actual situation on the ground while the VHR registry gave real physical data which was representative and verifiable. The potential of the VHR outweighed that of the HIS. Although the HIS had been rolled out nationally, there were shortfalls which MoH could consider rectifying to reach its full potential. In conclusion, the VHR was worth adopting as it would give MoH realistic statistics to be effectively used at all levels.Keywords: Village Health Register, Mwanza district, Ministry of Health, Community Health Workers, Health Information System. 

scholarly journals Evaluation of the Michigan Disease Surveillance System for Histoplasmosis Reporting

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Veronica A. Fialkowski ◽  
Leigh M. Tyndall Snow ◽  
Kimerbly Signs ◽  
Mary Grace Stobierski
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Increasing Trend ◽  
Control And Prevention ◽  
Over Time

The histoplasmosis surveillance system was evaluated using the 2001Centers for Disease Control and Prevention Updated Guidelines for Evaluating Public Health Surveillance Systems. From 2004 to 2014, a total of 1,608 confirmed or probable cases were reported into MDSS, with a slight increasing trend in case numbers over time. Michigan’s histoplasmosis surveillance system is relatively simple, but the misclassification of cases is troublesome. Development of tools for LHDs to aid in classification of cases may improve the PPV and decrease case investigation time. Increasing the number of hospitals that report directly to MDSS would indicate more acceptability, and increase sensitivity.

Sign in / Sign up

Export Citation Format

Share Document