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      Comparative Assessment of the Implementation of Integrated Disease Surveillance and Response in Public and Private Health Facilities in Jos North Local Government Area of Plateau State, Nigeria

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          Abstract

          Background:

          Due to the continuous increase in the spread of epidemic-prone diseases and the associated morbidity and mortality, integrated disease surveillance and response (IDSR) was introduced as the main strategy in resource-poor settings for the detection and notification of these diseases. Integrated disease surveillance is a combination of active and passive systems using a single infrastructure that gathers information about multiple diseases or behaviors of interest.

          Methods:

          A comparative cross-sectional study was conducted between March and July 2018 among selected public and private health facilities in Jos North Local Government Area (LGA), Plateau State. Quantitative data were collected with the aid of a semi-structured interviewer-administered questionnaire and facility-based checklist. Data were analyzed using SPSS version 23. Statistical significance level was set at P ≤ 0.05 at a 95% confidence level.

          Results:

          A total of 126 health workers were studied. IDSR-trained health personnel was found in 52.7% of the public health facilities compared with only 16.7% of the private health facilities studied ( P < 0.001). Awareness of IDSR was higher in the public health facilities than in the private ones ( P < 0.001). IDSR implementation was poorer in the private health facilities 40.7% compared with 76.4% in public health facilities ( P < 0.001). Evidence of previous disease notification and reporting was seen only in 33.3% and 16.7% of public and private health facilities, respectively ( P < 0.001).

          Conclusion:

          This study revealed that awareness and attitude of health workers in public health facilities in Jos North were higher than that of those in private health facilities and there is the sub-optimal implementation of IDSR among the health workers in Jos North LGA, especially among the private health facilities.

          Résumé

          Contexte:

          En raison de l'augmentation continue de la propagation des maladies à potentiel épidémique et de la morbidité et de la mortalité associées, la surveillance intégrée des maladies et la riposte (IDSR) ont été introduites comme principale stratégie dans les milieux pauvres en ressources pour la détection et la notification de ces maladies. La surveillance intégrée des maladies est une combinaison de systèmes actifs et passifs utilisant une infrastructure unique qui recueille des informations sur plusieurs maladies ou comportements d'intérêt.

          Méthodes:

          Une étude transversale comparative a été menée entre mars et juillet 2018 auprès d'établissements de santé publics et privés sélectionnés dans la zone de gouvernement local (LGA) de Jos North, dans l'État du Plateau. Les données quantitatives ont été recueillies à l'aide d'un questionnaire semi-structuré administré par un enquêteur et d'une liste de contrôle basée sur l'établissement. Les données ont été analysées à l'aide de la version 23 de SPSS. Le niveau de signification statistique a été fixé à P = 0,05 à un niveau de confiance de 95 %.

          Résultats:

          Au total, 126 agents de santé ont été étudiés. Le personnel de santé formé par l'IDSR a été trouvé dans 52,7 % des établissements de santé publics, contre seulement 16,7 % des établissements de santé privés étudiés ( P < 0,001). La sensibilisation à la SIMR était plus élevée dans les établissements de santé publics que dans les établissements privés ( P < 0,001). La mise en œuvre de la SIMR était plus faible dans les établissements de santé privés, 40,7 % contre 76,4 % dans les établissements de santé publics ( P < 0,001). Des preuves de notification et de notification antérieures de la maladie n'ont été observées que dans 33,3 % et 16,7 % des établissements de santé publics et privés, respectivement ( P < 0,001).

          Conclusion:

          Cette étude a révélé que la sensibilisation et l'attitude des agents de santé dans les établissements de santé publics de Jos North étaient plus élevées que celles des établissements de santé privés et qu'il existe une mise en œuvre sous-optimale de la SIMR parmi les agents de santé de Jos North LGA, en particulier parmi les les formations sanitaires privées.

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          Most cited references18

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          Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned.

          Despite a realistic strategy and availability of resources, multiple challenges still overwhelm countries grappling with the challenges of communicable disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy is by far the most pragmatic strategy in resource-poor settings. The objective of this study was to systematically review and document the lessons learned and the challenges identified with the implementation of the IDSR in low- and middle-income countries and to identify the main barriers that contribute to its sub-optimal functioning.
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            IDSR as a platform for implementing IHR in African countries.

            Of the 46 countries in the World Health Organization (WHO) African region (AFRO), 43 are implementing Integrated Disease Surveillance and Response (IDSR) guidelines to improve their abilities to detect, confirm, and respond to high-priority communicable and noncommunicable diseases. IDSR provides a framework for strengthening the surveillance, response, and laboratory core capacities required by the revised International Health Regulations [IHR (2005)]. In turn, IHR obligations can serve as a driving force to sustain national commitments to IDSR strategies. The ability to report potential public health events of international concern according to IHR (2005) relies on early warning systems founded in national surveillance capacities. Public health events reported through IDSR to the WHO Emergency Management System in Africa illustrate the growing capacities in African countries to detect, assess, and report infectious and noninfectious threats to public health. The IHR (2005) provide an opportunity to continue strengthening national IDSR systems so they can characterize outbreaks and respond to public health events in the region.
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              The implementation of Integrated Disease Surveillance and Response in Uganda: a review of progress and challenges between 2001 and 2007

              Background In 2000 Uganda adopted the Integrated Disease Surveillance and Response (IDSR) strategy, which aims to create a co-ordinated approach to the collection, analysis, interpretation, use and dissemination of surveillance data for guiding decision making on public health actions. Methods We used a monitoring framework recommended by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)-Atlanta to evaluate performance of the IDSR core indicators at the national level from 2001 to 2007. To determine the performance of IDSR at district and health facility levels over a 5-year period, we compared the evaluation results of a 2004 surveillance survey with findings from a baseline assessment in 2000. We also examined national-level funding for IDSR implementation during 2000–07. Results Our findings show improvements in the performance of IDSR, including: (1) improved reporting at the district level (49% in 2001; 85% in 2007); (2) an increase and then decrease in timeliness of reporting from districts to central level; and (3) an increase in analysed data at the local level (from 10% to 47% analysing at least one target disease, P < 0.01). The case fatality rate (CFR) for two target priority diseases (cholera and meningococcal meningitis) decreased during IDSR implementation (cholera: from 7% to 2%; meningitis: from 16% to 4%), most likely due to improved outbreak response. A comparison before and after implementation showed increased funding for IDSR from government and development partners. However, funding support decreased ten-fold from the government budget of 2000/01 through to 2007/08. Per capita input for disease surveillance activities increased from US$0.0046 in 1996–99 to US$0.0215 in 2000–07. Conclusion Implementation of IDSR was associated with improved surveillance and response efforts. However, decreased budgetary support from the government may be eroding these gains. Renewed efforts from government and other stakeholders are necessary to sustain and expand progress achieved through implementation of IDSR.
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                Author and article information

                Journal
                Ann Afr Med
                Ann Afr Med
                AAM
                Annals of African Medicine
                Wolters Kluwer - Medknow (India )
                1596-3519
                0975-5764
                Apr-Jun 2022
                06 July 2022
                : 21
                : 2
                : 146-152
                Affiliations
                [1 ]Department of Community Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
                [2 ]Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
                Author notes
                Address for correspondence: Dr. Y. O. Tagurum, Department of Community Medicine, Jos University Teaching Hospital, University of Jos, PMB 2076, Jos, Plateau State, Nigeria. E-mail: yetundetagurum@ 123456yahoo.com
                Article
                AAM-21-146
                10.4103/1596-3519.349974
                9383018
                35848647
                a1a01a2c-3a25-4551-a61d-860affb63856
                Copyright: © 2022 Annals of African Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 22 October 2020
                : 15 May 2021
                : 05 August 2021
                Categories
                Original Article

                integrated disease surveillance and response implementation,jos north local government area,public and private health facilities,surveillance intégrée des maladies et mise en œuvre de la riposte,zone de gouvernement local de jos north,établissements de santé publics et privés

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