The implementation of Integrated Disease Surveillance and Response in Uganda: a review of progress and challenges between 2001 and 2007

Abstract

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.

Assessment of the core and support functions of the Integrated Disease Surveillance system in Maharashtra, India

“…Weak data analysis at every level was observed on our study as from those in Ghana, Lesotho, Tanzania, Uganda and in other states of India [7,35,42,50,54-57]. The staff at the DSU is better trained and receives frequent feedback from the SSU as compared to facilities giving them a position of advantage for data analysis.…”

“…Nonetheless, several drawbacks have been identified with these programs and chief amongst them being their inability to fulfill surveillance functions adequately. Majority of them are heavily centralized and offer sub-optimal speed of surveillance, largely inadequate to detect outbreaks in a timely manner [6,7]. Duplication of efforts across multiple un-coordinated single disease control programs overburdens sub-national staff and are a waste of valuable resources [8,9].…”

Transfusion‐related adverse reactions reported to the National Healthcare Safety Network Hemovigilance Module, United States, 2010 to 2012

“…One reason for the relatively low proportion of participation may be the lack of a reporting mandate in the United States, as is present in many other countries . Previous studies have described that reduction of reporting requirements, simplifying case criteria, integrating electronic data capture, and maximizing access to and utility of submitted data can enhance and increase participation in surveillance systems …”

Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015

“…Since 2000, the MOH requires districts to regularly compile weekly reports from their health facilities and aggregate the data into a district summary report that is submitted to the central level in Kampala and used to produce a national level weekly surveillance report [18]. In 2015, Uganda had 112 districts which regularly compiled weekly reports: http://health.go.ug/content/weekly-epidemiological-bulletins.…”