Evaluation of the Disease Surveillance System in Adjumani District Refugee Settlements, Uganda, April 2017
Keywords:
surveillance system evaluation, refugee setting, uganda
Abstract
Background: Adjumani District in Uganda has hosted refugees in camps since the onset of the South Sudan conflict in Dec 2013. Since then, Adjumani refugee settlements have experienced measles, cholera, and hepatitis E outbreaks. Health care, disease surveillance, and response for these refugees is carried out by both government health facilities and nongovernmental organizations (NGOs) using the Integrated Disease Surveillance and Response (IDSR) guidelines. Methods: We evaluated attributes of the surveillance system using CDC MMWR 2001 guidelines for public health surveillance as a reference. Timeliness was defined as proportion of reports received by the monthly due dates at the MOH. We interviewed District Health Team and health facility staff using a standardized questionnaire to determine their readiness to conduct IDSR, and used a checklist to ascertain the availability of surveillance tools. Results: The surveillance system was adequate regarding stability, acceptability, and representativeness. NGO health facilities used HIS, which lacked some variables in the standard HMIS used by the MOH. We found poor timeliness [56%] and reporting rates [63%] across all diseases. The District Rapid Response Team [DRRT] and Epidemic Preparedness and Response Committee functioned only in confirmed outbreaks, and had no planning and review meetings. Conclusions: The surveillance and response exist in Adjumani District but do not operate optimally. There was lack of harmonization between NGO surveillance activities and government health facility surveillance activities. We recommended harmonization of the HIS and HMIS reporting system in the district, and provision of appropriate recording and reporting tools by the District Health Officer.
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2018-03-15
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