Conducting a surveillance problem analysis on poor feedback from Reference Laboratory, Liberia, February 2016.

The laboratory plays a major role in surveillance, including confirming the start and end of an outbreak. Knowing the causative agent for an outbreak informs the development of response strategies and management plans for a public health event. However, issues and challenges may arise that limit the effectiveness or efficiency of laboratories in surveillance. This case study applies a systematic approach to analyse gaps in laboratory surveillance, thereby improving the ability to mitigate these gaps. Although this case study concentrates on factors resulting in poor feedback from the laboratory, practise of this general approach to problem analysis will confer skills required in analysing most public health issues. This case study was developed based on a report submitted by the district surveillance officer in Grand Bassa County, Liberia, as a resident of the Liberian Frontline Field Epidemiology Training Program in 2016. This case study will serve as a training tool to reinforce lectures on surveillance problem analysis using the fishbone approach. It is designed for public health training in a classroom setting and can be completed within 2 hours 30 minutes.