Background: Planning and monitoring vaccine introduction and effectiveness relies on strong vaccine-preventable disease (VPD) surveillance. In low and middle-income countries (LMICs) especially, cost is a commonly reported barrier to VPD surveillance system maintenance and performance; however, it is rarely calculated or assessed. This review describes and compares studies on the availability of cost information for VPD surveillance systems in LMICs to facilitate the design of future cost studies of VPD surveillance. Methods: PubMed, Web of Science, and EconLit were used to identify peer-reviewed articles and Google was searched for relevant grey literature. Studies selected described characteristics and results of VPD surveillance systems cost studies performed in LMICs. Studies were categorized according to the type of VPD surveillance system, study aim, the annual cost of the system, and per capita costs. Results: Eleven studies were identified that assessed the cost of VPD surveillance systems. The studies assessed systems from six low-income countries, two low-middle-income countries, and three middle-income countries. The majority of the studies (n = 7) were conducted in sub-Saharan Africa and fifteen distinct VPD surveillance systems were assessed across the studies. Most studies aimed to estimate incremental costs of additional surveillance components and presented VPD surveillance system costs as mean annual costs per resource category, health structure level, and by VPD surveillance activity. Staff time/personnel cost represents the largest cost driver, ranging from 21% to 61% of total VPD surveillance system costs across nine studies identifying a cost driver. Conclusions: This review provides a starting point to guide LMICs to invest and advocate for more robust VPD surveillance systems. Critical gaps were identified including limited information *
Objective1) To establish One Health workgroups and conduct an e-Surveillance assessment to inform national strategic planning efforts in pilot countries. 2) To provide evidence for the African Surveillance Informatics Governance Board (ASIGB) to address its mission of establishing e-Surveillance. IntroductionInformation and Communication Technology (ICT) can enhance public health surveillance (PHS) by facilitating the digital exchange of information. Electronic surveillance (e-Surveillance) is the use of electronic systems to empower the digitization of PHS functions of prevention, detection, and response. E-Surveillance maximizes compliance with the International Health Regulations (2005), enables efficient Integrated Disease Surveillance and Response, and empowers One Health.In Africa, e-Health is hindered by donor-funded, short-term projects known as "pilotitus." Proactive national leadership is required to establish a sustainable e-Surveillance program; an assessment and a strategic plan are the first steps.
ObjectiveTo conceive and develop a model to identify gaps in public health surveillance performance and provide a toolset to assess interventions, cost, and return on investment (ROI). IntroductionUnder the revised International Health Regulations (IHR [2005]) one of the eight core capacities is public health surveillance. In May 2012, despite a concerted effort by the global community, the World Health Organization (WHO) reported out that a significant number of member states would not achieve targeted capacity in the IHR (2005) surveillance core capacity.Currently, there is no model to identify and measure these gaps in surveillance performance. Likewise, there is no toolset to assess interventions by cost and estimate the ROI.We developed a new conceptual framework that: (1) described the work practices to achieve effective and efficient public health surveillance; (2) could identify impediments or gaps in performance; and (3) will assist program managers in decision making. MethodsPublished articles and grey-literature reports, manuals and logic model examples were gathered through a literature review of PubMed, Web of Science, Google Scholar, and other databases. Logic models were conceived by categorizing discrete surveillance inputs, activities, outputs, and outcomes. Indicators were selected from authoritative sources or developed and then mapped to the logic model elements. These indicators will be weighted using the principle component analysis (PCA), a method for enhanced precision of statistical analysis. Finally, on the front end of the tool, indicators will graphically measure the surveillance gap expressed through the tool's architecture and provide information using an integrated cost-impact analysis. ResultsWe developed five public health surveillance logic models: for IHR (2005) compliance; event-based; indicator-based; syndromic; and predictive surveillance domains. The IHR (2005) domain focused on national-level functionality, and the others described the complexities of their specific surveillance work practices. Indicators were then mapped and linked to all logic model elements. ConclusionsThis new framework, intended for self-administration at the national and subnational levels, measured public health surveillance gaps in performance and provided cost and ROI information by intervention. The logic model framework and PCA methodology are tools that both describe work processes and define appropriate variables used for evaluation. However, both require real-world data. We recommend pilot testing and validation of this new framework. Once piloted, the framework could be adapted for the other IHR (2005) core capacities.
ObjectiveTo develop a toolset to monitor and assess laboratory biosafety program performance and cost IntroductionLaboratory biosafety -a component of biosecurity -has specific elements that together, comprise a facility's capability to both protect employees and the surrounding public and environment. Measuring these elements permits assessment and the costing of program-specific safety interventions. In the absence of a strategy and toolset, we developed a conceptual framework and toolset that monitors and assesses laboratory biosafety programs (LBPs) and provides useful information (e.g., return on investment [ROI]) for decision makers. MethodsWe conducted academic and open source literature reviews of LBPs and affiliated organizations laboratory manuals to identify objectives, goals, and indicators. These findings were aligned to laboratory biosafety-specific inputs, activities, outputs, and outcomes to create a strategic, conceptual framework (logic models) used to assess performance and measure the cost and ROI. Indicators were identified in existing literature or developed and mapped to the logic model elements. ResultsSix logic models were created: laboratory biosafety, biosurety, procedural, biocontainment, information security, and training. The laboratory biosafety logic model served as the overall framework for the remaining five sub-logic models. We also established a database containing 161 indicators mapped to each of the logic model elements. ConclusionsWe developed a strategic framework that monitors and evaluates LBPs. While evaluation of cost-impacts in LBPs provides business intelligence for resource planning, this integrated approach also provides information about gaps. We plan to pilot this toolset and refine indicators using principal component analysis.
A recent assessment of the Sudan public health surveillance system found fragmented and siloed disease programs and an overburdened workforce due to vertical systems and inefficient processes. A plan of action was developed to support improving public health surveillance strengthening by: 1) implementing a strategic approach to achieving IHR (2005), 2) implementing One Health and IDSR aims, and 3) establishing an E-surveillance ICT platform for increasing public health surveillance capacity to safely and rapidly detect and report infectious diseases in Sudan.
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