Integrated disease surveillance and response implementation in Liberia, findings from a data quality audit, 2017

Abstract

Introduction in spite of the efforts and resources committed by the division of infectious disease and epidemiology (DIDE) of the national public health institute of Liberia (NPHIL)/Ministry of health to strengthening integrated disease surveillance and response (IDSR) across the country, quality data management system remains a challenge to the Liberia NPHIL/MoH (Ministry of health), with incomplete and inconsistent data constantly being reported at different levels of the surveillance system. As part of the monitoring and evaluation strategy for IDSR continuous improvement, data quality assessment (DQA) of the IDSR system to identify successes and gaps in the disease surveillance information system (DSIS) with the aim of ensuring data accuracy, reliability and credibility of generated data at all levels of the health system; and to inform an operational plan to address data quality needs for IDSR activities is required. Methods multi-stage cluster sampling that included stage 1: simple random sample (SRS) of five counties, stage 2: simple random sample of two districts and stage 3: simple random sample of three health facilities was employed during the study pilot assessment done in Montserrado County with Liberia institute of bio medical research (LIBR) inclusive. A total of thirty (30) facilities was targeted, twenty nine (29) of the facilities were successfully audited: one hospital, two health centers, twenty clinics and respondents included: health facility surveillance focal persons (HFSFP), zonal surveillance officers (ZSOs), district surveillance officers (DSOs) and County surveillance officers (CSOs). Results the assessment revealed that data use is limited to risk communication and sensitization, no examples of use of data for prioritization or decision making at the subnational level. The findings indicated the following: 23% (7/29) of health facilities having dedicated phone for reporting, 20% (6/29) reported no cell phone network, 17% (5/29) reported daily access to internet, 56.6% (17/29) reported a consistent supply of electricity, and no facility reported access to functional laptop. It was also established that 40% of health facilities have experienced a stock out of laboratory specimens packaging supplies in the past year. About half of the surveyed health facilities delivered specimens through riders and were assisted by the DSOs. There was a large variety in the reported packaging process, with many staff unable to give clear processes. The findings during the exercise also indicated that 91% of health facility staff were mentored on data quality check and data management including the importance of the timeliness and completeness of reporting through supportive supervision and mentorship; 65% of the health facility assessed received supervision on IDSR core performance indicator; and 58% of the health facility officer in charge gave fe...

Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

“…The quality of data management system remains a challenge, with incomplete and inconsistent data constantly being reported at different levels of the surveillance system. In Ethiopia, Liberia and Tanzania, assessments of the information systems have identi ed some data quality issues and lack of use of the generated data [45,56,72,83,84]. In a study in Ethiopia, though the surveillance system was found to be simple, useful, exible, acceptable and representative, it lacked regular data analysis and feedback dissemination [35].…”

“…There are reports of a few countries (Burkina Faso, Ghana, Liberia, Uganda) that analyse and use routine HMIS data at sub-national levels in Africa [29,45]. In terms of data utilisation, in both Tanzania [56] and Liberia [45], it was found that analysis and data-use have not been given adequate attention. Underutilization of IDSR data at all levels of the health system was reported as a result of poor data management and analysis skills.…”

Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

“…The quality of data management system remains a challenge, with incomplete and inconsistent data constantly being reported at different levels of the surveillance system. In Ethiopia, Liberia and Tanzania, assessments of the information systems have identi ed some data quality issues and lack of use of the generated data [45,56,72,83,84]. In a study in Ethiopia, though the surveillance system was found to be simple, useful, exible, acceptable and representative, it lacked regular data analysis and feedback dissemination [35].…”

Improving dog bite victim survey and estimation of annual human deaths due to suspected rabies cases in three selected Liberian cities and environs, 2008–2017

“…A government health facility, the Tellowayan Memorial Hospital (TMH) alone reported DBVs to the MoHSW in 2008-2013. However, by 2017 some 20 other clinics/hospitals reported DBVs to the LNIH, in addition to TMH [14]. https://doi.org/10.1371/journal.pntd.0008957.g001…”

“…Deterministic model for forecasting 2014-2016 missed DBV data. Due to the prevailing challenges of EVD epidemic in West African that resulted in severe humanitarian crisis of international concern [14,18], no human hospital records of dog bite victims in 2014-2016 were available to the authors at the county reference hospitals and at the Liberian NIH. Thus, we utilized predicted case of DBVs from deterministic model of projected data for 2014-2017 expected for Buchanan, Gbarnga and Voinjama.…”