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Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya. | LitMetric

AI Article Synopsis

  • - The transition of Kenya's public health surveillance from a standalone web system to an integrated District Health Information System 2 (DHIS2) aimed to improve outbreak response by providing better training to surveillance officers.
  • - An evaluation comparing 13 intervention counties (trained in DHIS2) with 13 comparisons (not trained) showed that the intervention led to significant increases in both completeness (from 45% to 62%) and timeliness (from 30% to 51%) of reporting.
  • - Challenges identified for poor reporting included lack of government budget support, insufficient airtime for reporting, health worker strikes, and issues with healthcare facility resources.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359619PMC
http://dx.doi.org/10.1186/s12889-020-09222-2DOI Listing

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