Level and Predicators of quality of Integrated Disease Surveillance and Response for Infectious Disease in Tigray, Northern Ethiopia: Cross-Sectional Study

Abstract

Background: The health impacts of recent global infectious disease outbreaks have demonstrated the importance of strengthening public health systems. The aim of the study was to assess the level of quality of integrated disease surveillance and response for infectious disease in public health facilities of Tigray, Northern Ethiopia. Methods: the study was facility based cross-sectional. It was conducted from June- July 2018 in 46 health facilities. It has involved mixed method approach both quantitative and qualitative data collection methods. Donabedian input-process-output quality assessment model was used to evaluate the service. The magnitude of the association was considered at p-value of ≤0.05 in multivariable logistic regression analysis using adjusted odds ratio (AOR) at 95% confidence interval (CI). Concurrently, facility surveillance officers were subjected to an in-depth interview autonomously to explore factors for good and bad service quality. Quantitative data were analyzed using SPSS version 21. Use of manual thematic approach was used for qualitative data analysis. Result: The level of the overall quality of IDSR service provision has rendered as good in 6 out of 46(13%) studied health facilities. Two third of studied health facilities were rated as good for input service quality but 34.7% for process service quality. The output service quality was two times better than the overall service quality. Being enrollment of HIT to rapid response team (AOR=7, 95% CI: 1.092- 37.857) and accessing technical guideline to the health facility (AOR=3, 95% CI: 0.399-22.567) were predictor factors for facilitating overall service quality.

Integrated Disease Surveillance Response Practice and Associated Factors Among Health Professionals Working in Public Hospitals in West Hararghe Zone, Eastern Oromia, Ethiopia: Multi-Center Cross-Sectional Study

“…This finding is higher than the study done in Jordan 13 and the Eastern part of Nigeria 21 in which only 39.50% and 25.20% of health-care providers had a good level of IDSR practice, respectively. On the contrary, the result of this study showed a lower level of IDRS practice compared to the study conducted in Egypt, 14 Nigeria, 27 Kingdom of Bahrain 8 and in the Tigray region of Ethiopia, 19 which revealed 68.70%, 63.50%, 80.01%, and 80.40% good level of IDSR practice, respectively. The reason for this discrepancy might be knowledge differences, low organizational support, the country’s educational curriculum, and the complexity of reporting systems and study areas.…”

“…A total score of 20 and above was taken as good, and a score less than 20 was considered poor. 19 Perceived technical competency of IDSR: is defined in terms of data collection design, use of technology for data entry, analysis, and format friendly and measured by Five Point Likert scale questionnaire. A total of six questions were computed to construct the technical competency factor and scored out of 30, a score of 24 and above was reported as good technical competency, and a score less than 24 was reported as poor technical competency.…”

“…Lack of organizational support, poor knowledge, lack of time or workload, procedure complexity, inadequate resources, transport and communication challenges, perceptions, lack of regular data analysis and interpretation, absence of feedback, poor staff motivation, lack of staff, lack of training and weak supervision were factors linked to poor IDSR practice and reported to affect the overall implementation of the IDSR system. 5 , 8 , 19–24 Like other resource-restricted countries, in Ethiopia, recurrent and unexpected disease outbreaks are continually confronting the public health system. The management of health consequences of natural and human-made disasters, emergencies, crises, wars, and conflicts is challenging the detection and response to outbreaks and continues to disrupt the already fragile healthcare system in the country.…”

“…Due to these problems, the detection and response to outbreaks are becoming complicated. 19 , 20 , 25 …”

“… 25 Despite the achieved improvement through IDSR evidenced in Ethiopia, the overall implementation status of the system is not satisfactory. 19 , 20 , 25 In Dawuro zone, Southwestern Ethiopia, 64.3% of health centers had a reporting system, of which 35.7% reported sending in surveillance reports by hand delivery, 25 while the overall quality of IDSR service provision was good in 13% of health facilities in Tigray region, Northern Ethiopia. 19 …”