Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries

Abstract

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening.With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention.We describe two ways that health ministries in developing countries could leverage President Obama’s Global Health Initiative (GHI) to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM]) can also adapt their current health systems strengthening programs to build sustainable public health systems.

Ebola Virus Disease Surveillance and Response Preparedness in Northern Ghana

“…EVD surveillance support functions and response preparedness The findings from this study demonstrate that supervision for surveillance at the district or hospital is rather irregular and also not for Ebola, which supports previous findings (13,14). Although there is some improvement in the training and employment of disease control officers, they remain inefficient and ineffective.…”

“…Largely, it revealed challenges regarding reliability of clinically diagnosed data, accuracy, staff competencies, and commitment. The reported challenges with the rumoured EVD cases are likely attributable to negative attitudes of staff, lack of commitment, fear and panic, lack of PPE, and general lack of skills and competency among health workers, as previously reported in SSA countries (11,13). Previous studies in northern Ghana indicated that IDSR strategy has contributed to increased surveillance report submission as well as analysis of surveillance data (20).…”

Leptospirosis and malaria as causes of febrile illness during a dengue epidemic in Jamaica

“…It should be noted that leptospirosis diagnosis in Jamaica is primarily carried out by the veterinary services of the Ministry of Agriculture and that Jamaica's healthcare system could be improved by integrating testing for both leptospirosis and dengue in the same laboratory. 34 It was reported that the malaria epidemic was limited to western Kingston and was controlled and it was not unclear if positive IgG status represented antibodies from persons who were already free of malaria. 30 As Jamaica moves to re-establish its malaria-free status, serology may play an important role in highlighting geographic regions and at risk groups for malaria.…”

“…A similar age-prevalence pattern was seen in the 2005 epidemic in Singapore that occurred after successful control of dengue over many years. 34,35,36 In the case of malaria, the Jamaican population is likely to be uniformly immunologically naive and high prevalence at the extremes of age may be associated with mosquito biting rates. The prevalence of Leptospira IgM in suspected dengue cases in the inter-epidemic period of 2002-2007 was reported at 2.5%, 11 whereas the current estimate of 6.0% shows a clear epidemic.…”

Impact of Horizontal Approach in Vertical Program: Continuous Quality Improvement of Malaria and Tuberculosis Diagnostic Services at Primary-Level Medical Laboratories in the Context of HIV Care and Treatment Program in Ethiopia

“…3 Additionally, they are founding the framework of centralized quality systems at the national level, 4 with the overall goal of ensuring quality of testing at all laboratories levels. Thus, many countries in subSaharan Africa have allocated resources to expand national external quality assurance (EQA) schemes, mainly through panel testing for different analytes.…”